title: Oral theophylline and diuretics improve pulmonary mechanics in infants with bronchopulmonary dysplasia.
abstract: We studied the effects of orally administered theophylline and diuretics (chlorothiazide and spironolactone) on pulmonary mechanics in 16 infants with bronchopulmonary dysplasia. Their gestational age (mean +/- SD) was 28.5 +/- 3.4 weeks, and postnatal age at the time of study 19.5 +/- 10.7 weeks. The infants were randomized to two groups. Group 1 received successively placebo, theophylline, and theophylline plus diuretics; Group 2 received theophylline, placebo, and placebo plus diuretics on successive 4-day periods. Pulmonary function was measured before beginning the study (baseline) and at the end of each 4-day period. No significant changes in pulmonary function were noted after treatment with placebo. After treatment with theophylline, dynamic compliance (Cdyn) increased from baseline (mean +/- SD) 0.075 +/- 0.017 to 0.091 +/- 0.028 mL/cm H2O/cm (P less than 0.01), airway resistance (Raw) decreased from 67.19 +/- 36.71 to 41.44 +/- 22.50 cm H2O/L/sec (P less than 0.001), maximal expiratory flow at functional residual capacity (VmaxFRC) increased from 0.261 +/- 0.240 to 0.357 +/- 0.299 thoracic gas volume (TGV)/sec (P less than 0.01), and time constant decreased from 0.312 +/- 0.224 to 0.275 +/- 0.247 sec (P less than 0.02). After treatment with combined placebo and diuretics, Cdyn increased to 0.103 +/- 0.023 mL/cm H2O/cm (P less than 0.05), Raw decreased to 31.76 +/- 24.90 cm H2O/L/sec (P less than 0.001), VmaxFRC increased to 0.638 +/- 0.595 TGV/sec (P less than 0.02), and time constant decreased to 0.180 +/- 0.141 sec (P less than 0.05). After treatment with combined theophylline and diuretics, Cdyn increased to 0.118 +/- 0.017 mL/cm H2O/cm (P less than 0.001), Raw decreased to 35.98 +/- 25.85 cm H2O/L/sec (P less than 0.02), VmaxFRC increased to 0.479 +/- 0.377 TGV/sec (P less than 0.02), and time constant decreased to 0.180 +/- 0.137 sec (P less than 0.01). We conclude that theophylline and diuretics have additive effects on the improvement of pulmonary function in infants with bronchopulmonary dysplasia.
authors.forename: L C
authors.initials: LC
authors.lastname: Kao
authors.forename: D J
authors.initials: DJ
authors.lastname: Durand
authors.forename: B L
authors.initials: BL
authors.lastname: Phillips
authors.forename: B G
authors.initials: BG
authors.lastname: Nickerson
mesh_terms: D000284:Administration, Oral; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D002740:Chlorothiazide / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000187:drug effects*; D008176:Lung Volume Measurements; D012123:Pulmonary Ventilation / Q000187:drug effects; D011897:Random Allocation; D013148:Spironolactone / Q000627:therapeutic use*; D013806:Theophylline / Q000627:therapeutic use*
chemical_list: D013148:Spironolactone; D002740:Chlorothiazide; D013806:Theophylline