Faculty Collaboration Database

Management of diuretics in infants with bronchopulmonary dysplasia discharged on home oxygen. Pediatr Pulmonol 2023 Feb;58(2):522-529

Date

11/01/2022

Pubmed ID

36314365

DOI

10.1002/ppul.26221

Scopus ID

2-s2.0-85141976972 (requires institutional sign-in at Scopus site)

Abstract

BACKGROUND: Infants with bronchopulmonary dysplasia (BPD) are often prescribed diuretics before the neonatal intensive care unit (NICU) discharge. It is unknown whether outpatient medication weaning strategies affect the duration of home oxygen therapy.

METHODS: This was a secondary cohort analysis of infants born <32 weeks gestational age with BPD from 2015 to 2018 discharged from our NICU or regional NICUs, referred to our pulmonary clinic for home oxygen management. We compared three groups: those discharged with no diuretics, diuretics actively weaned (dose decreased), and diuretics passively weaned (dose not adjusted).

RESULTS: Out of 125 infants, 116 were included in the analysis. Forty-five infants were discharged without diuretics, 52 infants were discharged with diuretics that were actively weaned, and 19 infants were discharged with diuretics that were passively weaned. Infants who were passively weaned spent the most time on home oxygen (median 28 weeks, interquartile range [IQR] 16-52; p = 0.011); there were no differences in home oxygen duration in infants actively weaned (median 13 weeks, IQR 10-26) versus not on diuretics (median 22 weeks, IQR 12-30, p = 0.285). Multivariable adjustment for other illness characteristics associated with the duration of home oxygen did not change this finding.

CONCLUSIONS: Active weaning of diuretics did not prolong the duration of home oxygen, in the setting of a standardized clinical guideline for weaning home oxygen in infants with BPD. These data can serve as baseline information to implement and test standardized strategies for outpatient medication management.

Author List

Dawson SK, D'Andrea LA, Lagatta JM

Authors

Lynn A. D Andrea MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Joanne M. Lagatta MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bronchopulmonary Dysplasia
Diuretics
Humans
Infant
Infant, Newborn
Infant, Premature
Oxygen
Patient Discharge