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Changes in body water compartments with diuretic therapy in infants with chronic lung disease

J L Segar1, S Chemtob, E F Bell

  • 1Department of Pediatrics, University of Iowa, Iowa City 52242, USA.

Early Human Development
|April 25, 1997
PubMed

Insights

Diuretic therapy in preterm infants with chronic lung disease reduced extracellular water. Combination therapy with furosemide and metolazone increased urine output more effectively.

Area of Science:

  • Neonatal Medicine
  • Pediatric Nephrology
  • Respiratory Medicine

Background:

  • Chronic lung disease is common in preterm infants.
  • Fluid management is critical in these vulnerable infants.
  • Diuretics are often used to manage fluid overload.

Purpose of the Study:

  • To investigate the effects of diuretic therapy on body water compartments in preterm infants with chronic lung disease.
  • To compare the efficacy of furosemide alone versus furosemide plus metolazone.

Main Methods:

  • Randomized study of preterm infants (24-28 weeks gestational age) with chronic lung disease.
  • Infants received either furosemide alone or furosemide plus metolazone for 4 days.
  • Body water compartments, including extracellular water (ECW) and plasma volume (PV), were assessed.

Main Results:

  • Both treatment groups showed a significant decrease in ECW (P < 0.05) without changes in PV, total body water, or body weight.
  • The reduction in ECW was similar between the furosemide-only and combination therapy groups.
  • Combination therapy with furosemide and metolazone significantly increased urine output compared to furosemide alone.

Conclusions:

  • Diuretic therapy in preterm infants with chronic lung disease causes intercompartmental shifts in body water, reducing interstitial water while preserving plasma volume.
  • Combination therapy with furosemide and metolazone is more effective in inducing diuresis than furosemide alone.

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