Abstract
Introduction: During NICU hospitalization, children born
preterm with bronchopulmonary dysplasia (BPD) are frequently prescribed
diuretics for treatment of respiratory symptoms. However, less is known
about diuretic use and weaning in the outpatient setting. This study
sought to characterize clinical features associated with outpatient
diuretic use, and timing of diuretic weaning in children with BPD.
Methods: Data was obtained by chart review from registry 1224
participants born < 32 weeks gestation, discharged between
2008-2023 and recruited from outpatient BPD clinics at Johns Hopkins
Children’s Center and the Children’s Hospital of Philadelphia (97.4%
diagnosed with BPD). Data was analyzed using Chi-square tests, t-tests,
and ANOVA tests. Results: Children with BPD prescribed
diuretics as outpatients (n=737), were more likely to have lower birth
weights, earlier gestational age, and severe BPD compared to those not
on diuretics (n=487). Of those prescribed diuretics, most children were
on a thiazide alone (46.4%) or a thiazide and a potassium sparing agent
(44.8%) with a minority on loop diuretics alone (3.3%) or loop
diuretic combinations (4.7%). Most children weaned off diuretics by two
years of age. Public insurance, earlier gestational age, technology
dependence and loop diuretics were associated with slower diuretic
weaning. Conclusion: Outpatient diuretic use is common in BPD
with > 75% of children being weaned by two years of age.
No difference was found in weaning of home oxygen between children on
one versus no diuretic. Thiazides were most commonly prescribed with
slower outpatient diuretic weaning associated with public insurance,
technology dependence and loop diuretic use.