PEDIATRICS Vol. 74 No. 1 July 1984, pp. 37-44
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Effect of Oral Diuretics on Pulmonary Mechanics in Infants with Chronic Bronchopulmonary Dysplasia: Results of a Double-Blind Crossover Sequential Trial

Lily C. Kao MD1, David Warburton BSc, MB, MRCP1, Mary H. Cheng PhD1, Cecilia Cedeño MD1, Arnold C. G. Platzker MD1, and Thomas G. Keens MD1

1 From the Neonatal-Respiratory Disease Division and Clinical Laboratory, Childrens Hospital of Los Angeles; and Department of Pediatrics, University of Southern California School of Medicine, Los Angeles

In a randomized double-blind crossover trial with sequential analysis, the effects of oral diuretics were compared with the effects of placebo on pulmonary mechanics in ten infants with bronchopulmonary dysplasia (BPD). Pulmonary mechanics were measured before and at the end of a week of treatment with oral diuretics (chlorothiazide, 20 mg/kg/dose and spironolactone, 1.5 mg/kg/dose) given twice daily, or placebo. Mean airway resistance decreased 35.3 cm H2O/L/s, mean specific airway conductance increased 0.095 1/L/s/cm H2O, and mean dynamic pulmonary compliance increased 1.74 mL/cm H2O during treatment with diuretics (all P <.001), but not during treatment with placebo. The infants' rate of weight gain decreased on the first three days of diuretic treatment, but was thereafter comparable with weight gain during treatment with placebo. Fluid intake was similar in infants receiving diuretics and placebo. But, infants receiving diuretics not only had significantly increased urine output, osmolal clearance, and potassium and phosphorus excretion, but these infants also retained less fluid, and, in addition, excreted less calcium than infants receiving placebo. It is concluded that oral diuretics improve lung function in infants with chronic bronchopulmonary dysplasia; however, potassium and phosphorus depletion are potential complications of treatment.

Key Words: diuretics • pulmonary mechanics • bronchopulmonary dysplasia

Submitted on July 20, 1983




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