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Canadian Journal of Anesthesia, Vol 38, 502-505, Copyright © 1991 by Canadian Anesthesiologists' Society

ARTICLES

Supraventricular tachycardia associated with continuous furosemide infusion

NJ Wilson, RJ Adderley and JA McEniery
Department of Pediatrics, University of British Columbia, Vancouver, Canada.

Three cases of supraventricular tachycardia (SVT) associated with the use of furosemide infusion (FI) in children following cardiac surgery are reported. The SVT occurred three to seven hours after starting an infusion at 1.0 mg.kg-1.hr-1. All three patients had a diuresis of 8-10 ml.kg-1.hr-1 compared with a mean average of 2.5 ml.kg-1.hr-1 in 22 other patients who had received a similar infusion. A rapid fluid shift was the most likely mechanism of the tachycardia. Sotalol was effective in controlling the tachycardia in the two patients in whom it was tried. We now recommend a starting dose of 0.3 mg.kg-1.hr-1 in using furosemide as a continuous infusion, with hourly increments of 0.1 mg.kg-1.hr-1 until the desired diuresis is obtained.


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Copyright © 1991 by the Canadian Anesthesiologists' Society.