Publication | Closed Access
Effect of Oral Diuretics on Pulmonary Mechanics in Infants with Chronic Bronchopulmonary Dysplasia: Results of a Double-Blind Crossover Sequential Trial
118
Citations
0
References
1984
Year
Oral DiureticsNeonatologyChronic Bronchopulmonary DysplasiaPulmonary MechanicsPediatricsPediatric Lung DiseasePulmonary PhysiologyLung MechanicsPulmonary MedicineSequential AnalysisDiuretic ResistanceMedicinePulmonary DiseaseNeonatal Pulmonary Physiology
In a randomized double‑blind crossover trial, ten infants with BPD received a week of oral diuretics (chlorothiazide 20 mg/kg/dose and spironolactone 1.5 mg/kg/dose twice daily) or placebo, with pulmonary mechanics measured before and after each treatment period. Diuretic treatment lowered airway resistance by 35.3 cm H₂O/L/s, increased specific airway conductance by 0.095 1/L/s/cm H₂O, and raised dynamic pulmonary compliance by 1.74 mL/cm H₂O (all P < 0.001), while causing transient weight‑gain slowing and electrolyte depletion, but otherwise comparable fluid intake to placebo.
In a randomized double-blind crossover trial with sequential analysis, the effects of oral diuretics were compared with the effects of placebo on pulmonary mechanics in ten infants with bronchopulmonary dysplasia (BPD). Pulmonary mechanics were measured before and at the end of a week of treatment with oral diuretics (chlorothiazide, 20 mg/kg/dose and spironolactone, 1.5 mg/kg/dose) given twice daily, or placebo. Mean airway resistance decreased 35.3 cm H2O/L/s, mean specific airway conductance increased 0.095 1/L/s/cm H2O, and mean dynamic pulmonary compliance increased 1.74 mL/cm H2O during treatment with diuretics (all P less than .001), but not during treatment with placebo. The infants' rate of weight gain decreased on the first three days of diuretic treatment, but was thereafter comparable with weight gain during treatment with placebo. Fluid intake was similar in infants receiving diuretics and placebo. But, infants receiving diuretics not only had significantly increased urine output, osmolal clearance, and potassium and phosphorus excretion, but these infants also retained less fluid, and, in addition, excreted less calcium than infants receiving placebo. It is concluded that oral diuretics improve lung function in infants with chronic bronchopulmonary dysplasia; however, potassium and phosphorus depletion are potential complications of treatment.