Diuretics, hypochloremia, and outcome in bronchopulmonary dysplasia patients

Abstract

We evaluated retrospectively the outcome of patients with severe bronchopulmonary dysplasia who required hospitalization (greater than 90 days) to determine the role of diuretics aminophylline and chloride deficiency in the fatal outcome of these patients. Total cumulative amounts of furosemide, chlorothiazide, spironolactone accrued during hospitalization (dosage per patient per day), and a diuretic index (logarithm of the sum of the cumulative dosage of the three diuretics) were calculated for each patient. Other predetermined variables included in the analysis were birth weight, gestational age, duration of mechanical ventilation, duration of oxygen therapy, caloric intake, fluid and electrolyte intake, echocardiographic data, and duration and type of acid base balance disturbances. No differences were found between survivors and nonsurvivors in diuretic and aminophylline use. Hypochloremia did not discriminate between the groups. Duration of mechanical ventilation, the ratio between days with serum bicarbonate concentration greater than 30 mEq/l and total days of hospitalization, and the difference between head circumference at discharge or death and birth head circumferences were the most important factors which contribute to the difference between survivors and non survivors.