ORIGINAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 March;179(3):110-6

DOI: 10.23736/S0393-3660.19.04040-3

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

The effect of hydrochlorothiazide with spironolactone treatment on bronchopulmonary dysplasia development in very-low-birth-weight infants

Mehmet BUYUKTIRYAKI ✉, Evrim ALYAMAC DIZDAR, Nurdan URAS, Nilufer OKUR, Omer ERTEKIN, Serife S. OGUZ

Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey

BACKGROUND: The benefits of diuretic therapy in preterm infants developing bronchopulmonary dysplasia (BPD) have not yet been elucidated. To investigate the effect of combined administration of hydrochlorothiazide with spironolactone therapy on BPD development in very-low-birth-weight (VLBW) infants requiring respiratory support.
METHODS: We conducted a retrospective review of medical records of 174 preterm infants with gestational age of ≤30 weeks born between April 2014 and April 2015 at our tertiary neonatal intensive care unit. Among those, data of the preterm infants still requiring respiratory support on the postnatal 14th day, who received diuretic therapy to prevent BPD were compared with the infants who had never used diuretic therapy. Infants still having ductal patency on the 14th day or received any diuretic therapy before 14th day were excluded.
RESULTS: Mortality, BPD rate, duration of respiratory support, oxygen requirement, and hospitalization were also similar between the study groups. The prevalence of osteopenia of prematurity was found to be significantly higher in the diuretic group (P=0.015). Hyponatremia was also a significant side effect seen in the diuretic group (P<0.001).
CONCLUSIONS: Diuretic therapy in preterm infants >2weeks of age developing BPD has no benefit on the need for ventilatory support, oxygen requirement and bronchopulmonary dysplasia development while increasing the risk of hyponatremia and hypophosphatemia.

KEY WORDS: Bronchopulmonary dysplasia; Hydrochlorothiazide; Premature birth