In the setting of rapidly improving/worsening renal function, calculations of eGFR are inaccurate, and dosing should be based on estimated renal function instead.
If worsening renal function, actual GFR is likely lower than calculated.
If improving renal function, actual GFR is likely higher than calculated eGFR.
In infants with impaired renal function and those with moderate to severe HIE receiving induced hypothermia give an initial dose as per PNA and PMA above and order two post dose levels
Consult with NICU pharmacist for timing of levels
