Researchers from Children’s Hospital of Philadelphia (CHOP) announced findings from a new study that show outpatient diuretic use is common in children with bronchopulmonary dysplasia (BPD), and that factors such as gestational age, severity of BPD, and type of diuretic significantly influenced the timing of medication weaning. The study was published recently in Pediatric Pulmonology.
Diuretics are often prescribed to help reduce fluid buildup in the lungs of preterm babies with BPD, easing breathing difficulties. While their use is common in the hospital, less is known about medication management in an outpatient setting following discharge from the Neonatal Intensive Care Unit (NICU). This retrospective study aimed to bridge that gap by reviewing medical records from more than 1,000 babies diagnosed with BPD who were born before 32 weeks’ gestation between 2008 and 2023.
“Our findings show there are many variations in diuretic use among preterm babies with BPD in outpatient settings, influenced by the type of diuretic prescribed in the NICU, the child’s need for respiratory support, and other co-morbid health issues,” said Sharon A. McGrath-Morrow, MBA, MD, Associate Chief of the Division of Pulmonary and Sleep Medicine and leader of the Post-preemie Lung Disease Clinic at Children’s Hospital of Philadelphia. “We hope these insights highlight the importance of personalized care in managing BPD after discharge. We envision further research to optimize treatment strategies and improve outcomes for these vulnerable patients.”
The study found that babies prescribed diuretics at their first outpatient visit after leaving the NICU were born earlier, had lower birth weights, and had more severe BPD than those not given diuretics. Most were treated with thiazide diuretics, either alone or with potassium-sparing agents, as these medications gently remove excess fluid and are more commonly prescribed to babies with lung issues. In contrast, loop diuretics, which are stronger and can cause more significant electrolyte changes, were prescribed less often.
Researchers also found that most children were weaned off diuretics by the time they turned two years old. However, the length of time it took to wean them off diuretics varied significantly. Medication weaning was slower in babies taking loop diuretics, who were born very premature, needed ongoing respiratory support and whose families received public insurance. The authors also noted that diuretics might not directly affect the timing of when babies are weaned off supplemental oxygen, which was similar between those on one or no diuretics.
McGrath-Morrow et al. “Bronchopulmonary dysplasia and diuretic use in an outpatient setting.” Pediatr Pulmonol. Online August 22, 2024. DOI: 10.1002/ppul.27223.
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Researchers from Children’s Hospital of Philadelphia (CHOP) announced findings from a new study that show outpatient diuretic use is common in children with bronchopulmonary dysplasia (BPD), and that factors such as gestational age, severity of BPD, and type of diuretic significantly influenced the timing of medication weaning. The study was published recently in Pediatric Pulmonology.
Diuretics are often prescribed to help reduce fluid buildup in the lungs of preterm babies with BPD, easing breathing difficulties. While their use is common in the hospital, less is known about medication management in an outpatient setting following discharge from the Neonatal Intensive Care Unit (NICU). This retrospective study aimed to bridge that gap by reviewing medical records from more than 1,000 babies diagnosed with BPD who were born before 32 weeks’ gestation between 2008 and 2023.
“Our findings show there are many variations in diuretic use among preterm babies with BPD in outpatient settings, influenced by the type of diuretic prescribed in the NICU, the child’s need for respiratory support, and other co-morbid health issues,” said Sharon A. McGrath-Morrow, MBA, MD, Associate Chief of the Division of Pulmonary and Sleep Medicine and leader of the Post-preemie Lung Disease Clinic at Children’s Hospital of Philadelphia. “We hope these insights highlight the importance of personalized care in managing BPD after discharge. We envision further research to optimize treatment strategies and improve outcomes for these vulnerable patients.”
The study found that babies prescribed diuretics at their first outpatient visit after leaving the NICU were born earlier, had lower birth weights, and had more severe BPD than those not given diuretics. Most were treated with thiazide diuretics, either alone or with potassium-sparing agents, as these medications gently remove excess fluid and are more commonly prescribed to babies with lung issues. In contrast, loop diuretics, which are stronger and can cause more significant electrolyte changes, were prescribed less often.
Researchers also found that most children were weaned off diuretics by the time they turned two years old. However, the length of time it took to wean them off diuretics varied significantly. Medication weaning was slower in babies taking loop diuretics, who were born very premature, needed ongoing respiratory support and whose families received public insurance. The authors also noted that diuretics might not directly affect the timing of when babies are weaned off supplemental oxygen, which was similar between those on one or no diuretics.
McGrath-Morrow et al. “Bronchopulmonary dysplasia and diuretic use in an outpatient setting.” Pediatr Pulmonol. Online August 22, 2024. DOI: 10.1002/ppul.27223.
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