The Use of Diuretics in Infants with Established or Evolving Bronchopulmonary Dysplasia and Its Impact on the Duration of Home Oxygen Therapy.

Abstract

Objective: Bronchopulmonary dysplasia (BPD), defined according to the level of respiratory support and supplemental oxygen administered at 36 weeks postmenstrual age, has multi-factorial causes. Diuretics have been used to prevent or treat established BPD and are the most frequently prescribed medication for the management of severe BPD. There is significant variation in the use of diuretics, and there is limited evidence showing improvement in medium to long term outcomes. We explored whether the use of diuretics in infants with BPD reduced the duration of HoT in a service that uses a unified protocol-driven pathway to monitor and wean HoT.

Material and methods: A retrospective cohort study of 281 infants with BPD discharged home with oxygen therapy between 2001 and 2018. Of the 281 infants, 154 had complete data sets and were included in the study population.

Results and conclusions: Forty-nine infants (31.8%) were exposed to at least one diuretic, and 105 infants (68.2%) were not exposed to any. There was no difference in the duration of HoT in infants exposed to diuretics compared to those who were unexposed. Infants exposed to diuretics had a significantly longer length of stay (LoS) in the hospital compared to unexposed infants (P < .001). We conclude that in a setting of a service in which diuretics are actively discontinued post-discharge and in which weaning of HoT is driven by a unified protocol, the use of diuretics pre-discharge does not reduce the duration of HoT.