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Aerosolized diuretics for preterm infants with (or developing) chronic lung disease
L P Brion1, R A Primhak, W Yong
1Pediatrics, Division of Neonatology, Albert Einstein College of Medicine and Montefiore Medical Center, Weiler Hospital Room 725, 1825 Eastchester Road, Bronx, NY 10461, USA. brion@aecom.yu.edu
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Aerosolized furosemide may improve lung function in preterm infants over 3 weeks old with chronic lung disease (CLD). However, current evidence does not support routine use due to insufficient data on clinical outcomes and complications.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Preterm infants often develop lung edema, a complication of chronic lung disease (CLD).
- Aerosolized diuretics are considered for managing lung edema in these infants.
Purpose of the Study:
- To review the risks and benefits of aerosolized diuretic administration in preterm infants with or developing CLD.
- To assess effects on short-term and long-term outcomes, pulmonary mechanics, and potential complications.
Main Methods:
- Systematic review of randomized trials using keywords related to CLD and diuretics.
- Searched Medline, Embase, and Cochrane Controlled Trials Register.
- Included trials of preterm infants (≥5 days old) receiving aerosolized loop diuretics.
Main Results:
- Eight studies met criteria; most focused on physiological parameters, not clinical outcomes or complications.
- Furosemide was the only diuretic used.
- A single dose of aerosolized furosemide (1 mg/kg) may transiently improve pulmonary mechanics in infants >3 weeks with CLD.
Conclusions:
- A single dose of aerosolized furosemide improves pulmonary mechanics in preterm infants >3 weeks with CLD.
- Routine or sustained use is not recommended due to lack of data on clinical outcomes and complications.
- More randomized trials are needed to evaluate furosemide delivery, response factors, and long-term effects.