Diuretics reduce pulmonary edema in babies with bronchopulmonary dysplasia: Study

During the first week of therapy, diuretic administration is linked to a reduction in pulmonary edema and an improvement in oxygenation in babies with bronchopulmonary dysplasia (BPD), says an article published in Pediatric Pulmonology.

Lung damage with variable degrees of defective alveolarization, vascular remodeling, inflammatory cell proliferation, and pulmonary edema are characteristics of bronchopulmonary dysplasia. Diuretics are frequently used to treat BPD symptoms or stop its development. Therefore, the main goal of this study by Gangajal Kasniya and company was to employ lung ultrasonography (LUS) to ascertain if diuretics reduce pulmonary edema in babies with BPD. Assessing changes in respiratory support over the first week following the start of diuretics was the secondary goal.

In this study, a comparable group of newborns not receiving diuretics was compared to preterm infants needing non-invasive respiratory assistance and beginning diuretic medication for developing BPD (control). LUS tests were carried out before, on days 1, 3, and 6 following the start of medication for the diuretic group. LUS was done at comparable times for the control group. Based on the total number of B-lines in 6 scanned locations, a composite pulmonary edema severity (PES) score ranging from 0 to 5 was generated. Also monitored were the respiratory support parameters (FiO2, nasal cannula flow, or CPAP).

The key findings of this study were:

1. The median adjusted gestational ages of the infants in the diuretic (n=28) and control (n=23) groups were 34.2 (33.3-35.9) and 34.0 (33.4-36.3) weeks, respectively (p=0.82).

2. PES scores, FiO2, and respiratory flow support all declined significantly from day 0 to day 6 in the diuretic group but not in the control group (p.0001, p=0.001, and p=0.01, respectively).

Reference: 

Kasniya, G., Weinberger, B., Cerise, J., Pulju, M., Boyar, V., Frunza, F., & Kurepa, D. (2022). Lung Ultrasound Assessment of Pulmonary Edema in Neonates with Chronic Lung Disease Before and After Diuretic Therapy. In Pediatric Pulmonology. Wiley. https://doi.org/10.1002/ppul.26150