Randomized, double-blind, controlled trial of long-term diuretic therapy for bronchopulmonary dysplasia*

https://doi.org/10.1016/S0022-3476(89)80297-5Get rights and content

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 ≥30 days old, were supported by mechanical ventilation in ≥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.

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Supported by a grant from the Vancouver Foundation (British Columbia Medical Services Foundation 85-37). These findings were presented at the Society for Pediatric Research, Washington, D.C., May 5, 1988.

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Copyright © 1989 Published by Mosby, Inc.