Randomized, double-blind, controlled trial of long-term diuretic therapy for bronchopulmonary dysplasia.
The effects of continuous therapy with hydrochlorothiazide and spironolactone on pulmonary function in 34 premature infants with severe bronchopulmonary dysplasia were assessed in a randomized double-blind controlled trial. Subjects were greater than or equal to 30 days old, were supported by mechanical ventilation in greater than or equal to 30% oxygen, and had radiographic evidence of bronchopulmonary dysplasia. The treatment group (n = 19) and the placebo group (n = 15) were similar in all respects except for distribution of gender. Anthropometrics, ventilatory measurements, and the results of pulmonary function tests were evaluated at study entry and at 1, 4, and 8 weeks into therapy. Poststudy chest radiographs were compared with those obtained before the study. The proportion of infants alive at discharge was significantly increased (84%) in the treatment group compared with the placebo group (47%) (p = 0.05). There were no statistically significant differences in total hospital days or in total ventilator days. Total respiratory system compliance at 4 weeks was higher in the treatment group (0.61 +/- 0.18) than in the placebo group (0.45 +/- 0.13) (p = 0.016). No difference in outcome was detected between male and female infants in the treatment group. These results suggest that long-term diuretic therapy improves outcome in infants with bronchopulmonary dysplasia.
Albersheim
S G
SG
Department of Pediatrics, University of British Columbia, Vancouver, Canada.
Solimano
A J
AJ
Sharma
A K
AK
Smyth
J A
JA
Rotschild
A
A
Wood
B J
BJ
Sheps
S B
SB
D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D013148:Spironolactone / Q000627:therapeutic use*
D006852:Hydrochlorothiazide; D013148:Spironolactone