Document Detail


Variation in the use of diuretic therapy for infants with bronchopulmonary dysplasia.
MedLine Citation:
PMID:  23478874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine (1) between-hospital variation in diuretic use for infants with bronchopulmonary dysplasia (BPD), including hospital-specific treatment frequency, treatment duration, and percentage of infants receiving short (≤5 consecutive days) versus longer (>5 days) courses, and to determine (2) demographic and clinical variables associated with diuretic administration.
METHODS: A retrospective cohort study was conducted with the use of the Pediatric Health Information System to determine between-hospital variation in diuretic utilization patterns (primary outcome) and variables associated with diuretic use among <29-week-gestation infants with evolving BPD at age 28 days who were discharged between January 2007 and June 2011.
RESULTS: During the 54-month study period, 1429 infants within 35 hospitals met the inclusion criteria for BPD at age 28 days, with 1222 (86%) receiving diuretic therapy for a median of 9 days (25th-75th percentile: 2-33 days). Short courses were administered to 1203 (83%) infants, and 570 (40%) infants received treatment for >5 consecutive days. Furosemide was the most widely prescribed diuretic (1218 infants; 85%), although chlorothiazide had the longest median duration of use (21 days; 25th-75th percentile: 8-46 days). The range of infants receiving a diuretic course of >5 days duration varied by hospital from 4% to 86%, with wide between-hospital variation even after adjustment for confounding variables.
CONCLUSIONS: The frequency of diuretic administration to infants with BPD at US children's hospitals, as well as the specific diuretic regimen used, varies markedly by institution. Safety and effectiveness research of long-term diuretic therapy for BPD patients is needed to develop evidence-based recommendations.
Authors:
Jonathan L Slaughter; Michael R Stenger; Patricia B Reagan
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2013-03-11
Journal Detail:
Title:  Pediatrics     Volume:  131     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-02     Completed Date:  2013-05-20     Revised Date:  2014-04-01    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  716-23     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Bronchopulmonary Dysplasia / drug therapy*
Chlorothiazide / therapeutic use
Cohort Studies
Databases, Factual
Diuretics / therapeutic use*
Drug Administration Schedule
Drug Utilization / statistics & numerical data*
Female
Furosemide / therapeutic use
Hospitals, Pediatric / statistics & numerical data*
Humans
Infant, Newborn
Logistic Models
Male
Multivariate Analysis
Physician's Practice Patterns / statistics & numerical data*
Retrospective Studies
United States
Grant Support
ID/Acronym/Agency:
8KL2TR000112-05/TR/NCATS NIH HHS; KL2RR025754/RR/NCRR NIH HHS; R21 HS19524-01/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Diuretics; 77W477J15H/Chlorothiazide; 7LXU5N7ZO5/Furosemide
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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