Review: insufficient evidence exists for regular use of loop diuretics in preterm infants with chronic lung disease
QUESTION: In premature infants who have, or are developing, chronic lung disease (CLD), what are the short and long term benefits and risks of loop diuretics?
Studies were identified by searching Medline (1966 to August 2000); EMBASE/Excerpta Medica (1974–98); and the Cochrane Controlled Trials Register (1998, issue 3). Abstracts from 4 national and international societies (1991–8) and 4 annual scientific meetings were handsearched.
Randomised controlled trials were selected if they included preterm infants (<37 wks gestation) with oxygen dependency or ventilator dependency secondary to lung disease beyond 5 days of life and compared intravenous or enteral administration of a loop diuretic with placebo or no treatment, administration of an additional loop diuretic with a single diuretic, different diuretics, or different administration routes. Trials were selected if they reported short term outcomes (changes in mean airway pressure, need for artificial ventilation, need for continuous positive airway pressure, failure to tolerate extubation, and oxygen supplementation), long term outcomes (mortality, duration of need for oxygen supplementation and respiratory support, need for oxygen at 28 d, CLD at 36 wks postconceptional age, length of …