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Variability in duration of outpatient diuretic therapy in bronchopulmonary dysplasia: a clinical experience

Anita Bhandari1, Urey Chow, James I Hagadorn

  • 1Division of Pediatric Pulmonology, Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA. Abhanda@ccmckids.org

American Journal of Perinatology
|February 24, 2010
PubMed

Insights

Infants with bronchopulmonary dysplasia (BPD) on diuretics showed varied therapy durations. Discharge on oxygen correlated with longer diuretic treatment and tapering periods, but most infants successfully discontinued diuretics outpatient.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants.
  • Diuretic therapy is common in BPD management but optimal duration and tapering strategies are not well-defined.
  • Understanding factors influencing diuretic use in BPD is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the typical duration of outpatient diuretic therapy for infants with BPD.
  • To identify factors associated with the duration of diuretic tapering in these infants.
  • To evaluate the success rate of outpatient diuretic tapering.

Main Methods:

  • Retrospective chart review of infants with BPD discharged on diuretic therapy.
  • Exclusion of infants with chromosomal abnormalities, congenital heart disease, or tracheostomy.
  • Descriptive, univariate, and multivariate analyses, including Cox proportional hazards modeling.

Main Results:

  • Median outpatient diuretic therapy duration was 94 days; median taper duration was 30 days.
  • Infants discharged on oxygen had significantly longer therapy and taper durations.
  • Longer taper associated with higher chlorothiazide dose, shorter interval to first outpatient visit, rehospitalization, and African-American race.

Conclusions:

  • Significant variability exists in outpatient diuretic therapy and taper duration for BPD.
  • Discharge on oxygen is a key factor associated with prolonged diuretic use.
  • Outpatient diuretic tapering is successful in most infants with stable BPD and should be considered.

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