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Management of diuretics in infants with bronchopulmonary dysplasia discharged on home oxygen.
  • Sara Dawson,
  • Lynn D'Andrea,
  • Joanne Lagatta
Sara Dawson
Medical College of Wisconsin Department of Pediatrics

Corresponding Author:[email protected]

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Lynn D'Andrea
Medical College of Wisconsin Department of Pediatrics
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Joanne Lagatta
Medical College of Wisconsin Department of Pediatrics
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Abstract

Background: Infants with Bronchopulmonary Dysplasia (BPD) are often prescribed diuretics before the neonatal intensive care unit (NICU) discharge. It is unknown whether outpatient medication weaning strategies affect duration of home oxygen therapy. Methods: This was a secondary cohort analysis of infants born <32 weeks gestational age with BPD from 2015-2018 discharged from our NICU or regional NICUs, referred to our pulmonary clinic for home oxygen management. We compared three groups: those discharged with no diuretics, diuretics actively weaned (dose decreased) and diuretics passively weaned (dose not adjusted). Results: Out of 125 infants, 116 were included in the analysis. Forty-five infants were discharged without diuretics; 52 infants were discharged with diuretics that were actively weaned; 19 infants were discharged with diuretics that were passively weaned. Infants who were passively weaned spent the most time on home oxygen (median 28 weeks, IQR 16-52; p=0.011); there were no differences in home oxygen duration in infants actively weaned (median 13 weeks, IQR 10-26) versus not on diuretics (median 22 weeks, IQR 12-30, p=0.285). Multivariable adjustment for other illness characteristics associated with duration of home oxygen did not change this finding. Conclusions: Active weaning of diuretics did not prolong duration of home oxygen, in the setting of a standardized clinical guideline for weaning home oxygen in infants with BPD. These data can serve as baseline information to implement and test standardized strategies for outpatient medication management.
27 Jul 2022Submitted to Pediatric Pulmonology
27 Jul 2022Submission Checks Completed
27 Jul 2022Assigned to Editor
29 Jul 2022Reviewer(s) Assigned
12 Aug 2022Review(s) Completed, Editorial Evaluation Pending
14 Aug 2022Editorial Decision: Revise Major
30 Sep 20221st Revision Received
03 Oct 2022Submission Checks Completed
03 Oct 2022Assigned to Editor
03 Oct 2022Reviewer(s) Assigned
08 Oct 2022Review(s) Completed, Editorial Evaluation Pending
10 Oct 2022Editorial Decision: Revise Minor
17 Oct 20222nd Revision Received
17 Oct 2022Assigned to Editor
17 Oct 2022Review(s) Completed, Editorial Evaluation Pending
17 Oct 2022Submission Checks Completed
17 Oct 2022Reviewer(s) Assigned
23 Oct 2022Editorial Decision: Accept
Feb 2023Published in Pediatric Pulmonology volume 58 issue 2 on pages 522-529. 10.1002/ppul.26221