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Aerosolized diuretics for preterm infants with (or developing) chronic lung disease
L P Brion1, R A Primhak, W Yong
1Albert Einstein College of Medicine, Children's Hospital at Montefiore, Pediatrics, Section of Neonatology, Weiler Hospital Room 725, 1825 Eastchester Road, Bronx, NY 10461-2373, USA. lbrion@montefiore.org
The Cochrane Database of Systematic Reviews
|July 21, 2006
Summary
Aerosolized furosemide may improve pulmonary mechanics 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 disease complicated by edema.
- Chronic lung disease (CLD) is a significant concern in this population.
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 (oxygen/ventilator support) and long-term outcomes.
- To evaluate changes in pulmonary mechanics and potential complications.
Main Methods:
- Systematic review of randomized controlled trials using keywords related to CLD and diuretics.
- Searched MEDLINE, EMBASE, and CENTRAL databases up to March 2006.
- Included preterm infants (≥5 days old) receiving aerosolized loop diuretics, assessing predefined outcomes.
Main Results:
- Eight studies were identified; 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, but data on outcomes and chronic use are insufficient.
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 double-blinded randomized trials are needed to assess factors affecting response and long-term effects.
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