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A 2-year-old boy is admitted to the paediatric ward with a significant history of diarrhoea and vomiting, reduced urine output and signs of dehydration on examination. Despite giving adequate fluid replacement and maintenance, his urine output does not improve. Serial blood chemistry and urine analysis confirms evidence of worsening AKI. In this scenario, you wonder if administration of furosemide may help to ‘kick start’ and maintain urine output, ameliorate the need for dialysis and prevent long-term renal insufficiency.
Structured clinical question
In paediatric populations including neonates with AKI (Patient), is administration of intravenous furosemide subsequent to adequate intravascular volume replenishment (Intervention) in comparison with an expectant approach after adequate fluid replenishment associated with any short-term or long-term benefits or reduction in renal complications (Outcome)?
Search strategy and outcome
No relevant reviews were found in the Cochrane Library. A search in Medline and Embase completed in October 2014 produced 1023 titles using the following entry terms and strategies: [(‘ACUTE KIDNEY INJURY’[Mesh] OR ‘acute renal failure’[tiab]) AND (‘furosemide’[tiab] OR ‘FUROSEMIDE’[Mesh])] AND Limit to: (Age Groups Newborn Infant birth to 1 month or Infant 1 to 23 months or Preschool Child 2 to 5 years)+[(‘ACUTE KIDNEY INJURY’ [Mesh] OR ‘acute renal failure’ [tiab]) AND (ANOXIA [Mesh) OR hypoxi×OR ISCHEMIA [Mesh]] AND Limit …