title: Surfactant therapy and spontaneous diuresis.
abstract: The effect of artificial surfactant therapy on renal function and the onset of spontaneous diuresis was prospectively evaluated in 19 infants with hyaline membrane disease in a double-blind, controlled study. Twelve infants were in the surfactant group; seven infants received placebo (0.9% saline solution). There was no difference in the time of onset of spontaneous diuresis (as defined by output greater than or equal to 80% of intake). The glomerular filtration rate, determined by endogenous creatinine clearance, was also similar in the surfactant- and placebo-treated infants during the first 3 days of life. The fractional excretion of sodium was significantly higher in the placebo group at 24 hours and 36 hours. Infants in the placebo group had a higher negative sodium balance than those in the surfactant group. Ventilatory status improved significantly soon after surfactant treatment, as evidenced by improvement in the alveolar/arterial oxygen pressure ratio and by a lower mean airway pressure. These data suggest that ventilatory status can be improved without diuresis; the factors that regulate diuresis are multiple and not fully understood.
authors.affiliation: Department of Pediatrics, University of Illinois, Chicago.
authors.forename: R
authors.initials: R
authors.lastname: Bhat
authors.forename: E
authors.initials: E
authors.lastname: John
authors.forename: J
authors.initials: J
authors.lastname: Diaz-Blanco
authors.forename: R
authors.initials: R
authors.lastname: Ortega
authors.forename: L
authors.initials: L
authors.lastname: Fornell
authors.forename: D
authors.initials: D
authors.lastname: Vidyasagar
mesh_terms: D001784:Blood Gas Analysis; D001835:Body Weight; D002986:Clinical Trials as Topic; D004231:Diuresis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006819:Hyaline Membrane Disease / Q000188:drug therapy*; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D007668:Kidney / Q000502:physiology*; D008168:Lung / Q000502:physiology*; D008297:Male; D010919:Placebos; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D011897:Random Allocation
chemical_list: D010919:Placebos; D011663:Pulmonary Surfactants