Randomized, double-blind, controlled trial of long-term diuretic therapy for bronchopulmonary dysplasia

Laboratory studies performed on infants whose cause of death was abnormal development of the lungs (bronchopulmonary dysplasia), have revealed increased fluid levels within the lungs. This fluid collection may have been responsible for the poor lung function in these infants. Several experiments using diuretics to reduce excess fluid in the lungs have demonstrated improved pulmonary function. The use of diuretics, however, can cause a serious imbalance in the body's electrolytes. When the combination of the two diuretics, hydrochlorothiazide and spironolactone, are used there is less severe disruption of the electrolyte balance. In this study 34 premature infants with severe pulmonary dysplasia were studied. They were divided into a control group, which was not given any diuretic, and a treatment group, which received hydrochlorothiazide and spironolactone therapy for eight weeks. The group of infants who received long-term diuretic therapy showed a significantly higher survival rate (84 percent, versus 47 percent). The authors speculate that decreasing the fluid in the lungs, slowed down the development of scar tissue and permanent lung damage. There was no significant difference between the two groups in either total hospital stay, or in the number of days the infants needed to be on ventilators. The authors concluded that combination diuretic therapy can improve respiratory function while decreasing lung damage and increasing survival rates among patients with bronchopulmonary dysplasia. The side effects of this combination of diuretics were not too severe, permitting them to be used for relatively long-term therapy.