背景： 新生兒黃膽是常見的，而sulfisoxazole 與ceftriaxone 因強的蛋白質結合能力可能有造成核黃膽的疑慮，是禁用於新生兒。然而，有高蛋白質結合能力的藥物，如furosemide ( > 90%) 卻常常使用於非常低出生體重 (VLBW) 新生兒。
目的： 本研究之目的在瞭解是否靜脈furosemide 的使用會使得VLBW新生兒黃膽惡化。
方法： VLBW新生兒出生後10至30 天無任何感染跡象者均納入及計算其出血的程度與hemoglobin 波動情形。出血的程度與phototherapy 使用與否對血清總膽紅素值 (TSB) 的作用將被計算與使用來校正每一劑靜脈furosemide 對TSB 的影響。
結果： 此研究共納入96 名VLBW新生兒。再對hemoglobin 值變化及phototherapy 使用與否的校正後，平均TSB 值在靜脈furosemide 使用前後的差異為0.292 ± 1.478 mg/dL，此結果顯示靜脈furosemide 的使Furosemide, VLBW Neonate, Drug-Induced Hyperbilirubinemia 用於VLBW新生兒可稍微提升TSB 值。
結論： 儘管具有高蛋白質結合能力，短期（1 或2 天）靜脈給予furosemide 對VLBW新生兒的TSB 值沒有顯著影響 (n = 58, p = 0.138)。至於長期靜脈furosemide 使用於新生兒則需再進一步研究。
 

Background: Neonatal hyperbilirubinemia is common. Sulfisoxazole and ceftriaxone are known to be contraindicated in neonates with potential kernicterus because of the high protein-binding ability of these drugs. However, drugs with high protein-binding abilities, such as furosemide ( > 90 %),are commonly used in very low birth weight (VLBW) neonates.
Objectives: he aim of this study was to determine whether IV furosemide could deteriorate hyperbilirubinemia in VLBW neonates.
Methods: To determine the extent of blood loss and the hemoglobin levels of the VLBW neonates who exhibited no signs of infection > 10 days and ≤ 30 days following birth were recorded and calculated. The effects of blood loss and phototherapy use or not on the total serum bilirubin (TSB) levels were calculated and used to correct the influence of each intravenous (IV) dose of furosemide on the TSB levels.
Results: Ninety-six VLBW neonates were included in the study. Following corrections based on hemoglobin level changes and phototherapy use or not, the average difference between the TSB levels before and after IV furosemide use was 0.292 ± 1.478 mg/dL, which suggested that IV furosemide slightly elevated the TSB levels in VLBW neonates.
Conclusions: Despite the high protein-binding ability, short-term use (one or two days) of IV furosemide might not have significant impact on the TSB levels in VLBW neonates. (n = 58, P = 0.138) Further studies are required to evaluate the influence of long-term IV furosemide use in neonates.