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Variation in the use of diuretic therapy for infants with bronchopulmonary dysplasia

Jonathan L Slaughter1, Michael R Stenger, Patricia B Reagan

  • 1Department of Pediatrics, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, Ohio 43205, USA. slaughter.84@osu.edu

Pediatrics
|March 13, 2013
PubMed

Insights

Diuretic use for infants with bronchopulmonary dysplasia (BPD) varies significantly across US hospitals. Further research is needed to establish evidence-based guidelines for long-term diuretic therapy in BPD patients.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Clinical Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a common complication in premature infants.
  • Diuretics are frequently used in managing BPD, but treatment patterns vary.
  • Lack of standardized guidelines contributes to inconsistent therapeutic approaches.

Purpose of the Study:

  • To analyze between-hospital variations in diuretic use for infants with BPD.
  • To identify hospital-specific frequencies, durations, and course lengths (short vs. long) of diuretic therapy.
  • To determine demographic and clinical factors associated with diuretic administration in BPD.

Main Methods:

  • Retrospective cohort study using the Pediatric Health Information System.
  • Inclusion criteria: infants born <29 weeks gestation with BPD at 28 days, discharged between 2007-2011.
  • Primary outcome: diuretic utilization patterns and associated variables.

Main Results:

  • 1429 infants with BPD across 35 hospitals received diuretic therapy (86%) for a median of 9 days.
  • Short courses (≤5 days) were common (83%), but 40% received longer courses (>5 days).
  • Significant hospital variation existed in the percentage of infants receiving >5-day diuretic courses (4%-86%).

Conclusions:

  • Marked institutional variation in diuretic frequency and regimen for BPD infants in US children's hospitals.
  • Need for safety and effectiveness research on long-term diuretic therapy for BPD.
  • Development of evidence-based recommendations for diuretic use in BPD is crucial.
Abstract

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