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Diuretics for respiratory distress syndrome in preterm infants

L P Brion1, R F Soll

  • 1University of Texas Southwestern at Dallas, Division of Neonatal-Perinatal Medicine, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9063, USA. Luc.Brion@UTSouthwestern.edu

The Cochrane Database of Systematic Reviews
|February 7, 2008
PubMed

Insights

Diuretics like furosemide and theophylline offer no long-term benefits for preterm infants with respiratory distress syndrome (RDS). Their administration may increase risks such as patent ductus arteriosus and hemodynamic instability, outweighing any transient improvements.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pharmacology
  • Critical Care

Background:

  • Lung edema is a common complication in preterm infants with respiratory distress syndrome (RDS).
  • Diuretic administration is sometimes used to manage fluid overload in these infants.

Purpose of the Study:

  • To review the risks and benefits of using diuretics in preterm infants diagnosed with RDS.
  • To evaluate the impact of diuretic use on various clinical outcomes.

Main Methods:

  • Systematic review of randomized controlled trials identified through MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials.
  • Inclusion criteria focused on preterm infants (<5 days old) with RDS, randomly assigned to diuretic treatment.
  • Outcomes assessed included mortality, patent ductus arteriosus, renal function, and neurodevelopmental outcomes.

Main Results:

  • Furosemide, used in six studies predating current treatments, showed no long-term benefits and increased risks of patent ductus arteriosus and hemodynamic instability.
  • Theophylline, studied recently, did not demonstrate long-term benefits, although it transiently improved renal function and reduced oligoanuria.

Conclusions:

  • Current evidence does not support the routine use of furosemide in preterm infants with RDS.
  • The potential risks of furosemide, including hypovolemia and patent ductus arteriosus, necessitate careful consideration.
  • Insufficient data exist to recommend routine low-dose theophylline administration for preterm infants with RDS.
Abstract

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