title: Necrotizing enterocolitis and the use of loop diuretics in very low birth weight neonates.
abstract: BACKGROUND
  Necrotizing enterocolitis (NEC) is a gastrointestinal disease of premature, very low birth weight neonates resulting in sepsis and death. Loop diuretics are widely used in neonates as a treatment for pulmonary fluid retention. An association between diuretic use and NEC has not been explored.
  
  
  METHODS
  The medical records of all neonates admitted to Duke Children's Hospital between 2007 and 2012 with a birth weight ≤1,500 grams were reviewed.
  
  
  RESULTS
  Using multivariable logistic regression analysis, we found that loop diuretic administration was not a risk factor for the development of NEC. On subanalysis, 75% of medical NEC infants had prior exposure to loop diuretics, compared with 100% of surgical NEC infants (P = .004).
  
  
  CONCLUSIONS
  Loop diuretics do not increase the risk of development of NEC in very low birth weight neonates. However, on diagnosis of NEC, administration of loop diuretics may be associated with the progression of NEC severity from medical NEC to surgical NEC.
authors.affiliation: University of North Carolina, Chapel Hill School of Medicine, Chapel Hill, NC, USA.
authors.forename: Mariatu A
authors.initials: MA
authors.lastname: Cole
authors.affiliation: Division of Perinatal-Neonatal Medicine, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA; Department of Pediatrics, Jean and George Brumley, Jr., Neonatal-Perinatal Research Institute, Duke University Medical Center, Durham, NC, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: DeRienzo
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Maragatha
authors.initials: M
authors.lastname: Kutchibhatla
authors.affiliation: Division of Perinatal-Neonatal Medicine, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA; Department of Pediatrics, Jean and George Brumley, Jr., Neonatal-Perinatal Research Institute, Duke University Medical Center, Durham, NC, USA.
authors.forename: Charles Michael
authors.initials: CM
authors.lastname: Cotten
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Duke University Medical Center, DUMC Box 3815, Durham, NC 27710, USA. Electronic address: obinna.adibe@duke.edu.
authors.forename: Obinna O
authors.initials: OO
authors.lastname: Adibe
mesh_terms: D016022:Case-Control Studies; D018450:Disease Progression; D020345:Enterocolitis, Necrotizing / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D009657:North Carolina; D012720:Severity of Illness Index; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000008:administration & dosage*
chemical_list: D049994:Sodium Potassium Chloride Symporter Inhibitors
keywords: Loop diuretics; Necrotizing enterocolitis; Preterm; Very low birth weight