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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
|June 19, 2001
Summary
Aerosolized furosemide may transiently improve pulmonary mechanics in preterm infants over 3 weeks old with chronic lung disease (CLD). However, routine use is not recommended due to insufficient evidence on clinical outcomes and potential complications.
Area of Science:
- Neonatology
- Pulmonology
- Pharmacology
Background:
- Preterm infants often develop lung edema complicating lung disease.
- Chronic lung disease (CLD) is a common complication in preterm infants.
Purpose of the Study:
- To review the risks and benefits of aerosolized diuretic administration in preterm infants with or developing CLD.
- To assess short-term outcomes (oxygen/ventilator support) and long-term effects.
- To evaluate changes in 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 up to January 2001.
- Included trials of preterm infants (>=5 days old) receiving aerosolized loop diuretics.
Main Results:
- Eight studies were identified; most focused on physiological parameters, not clinical outcomes or complications.
- Furosemide was the only diuretic used.
- A single aerosolized dose of furosemide may transiently improve pulmonary mechanics in infants >3 weeks with CLD, but data on chronic use and outcomes is insufficient.
Conclusions:
- A single aerosolized furosemide dose improves pulmonary mechanics in preterm infants >3 weeks with CLD.
- Routine or sustained use of aerosolized loop diuretics is not recommended due to lack of evidence on clinical outcomes.
- More randomized trials are needed to assess factors affecting response and chronic administration effects on mortality and long-term outcomes.