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Review: insufficient evidence exists for regular use of loop diuretics in preterm infants with chronic lung disease

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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?

Data sources

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.

Study selection

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 …

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  • Source of funding: American Heart Association.

  • For correspondence: Dr L Brion, Pediatrics, Division of Neonatology, Albert Einstein College of Medicine and Montefiore Medical Center, Weiler Hospital, Room 725, 1825 Eastchester Road, Bronx, NY 10461, USA. Fax +1 718 904 2659.