Furosemide Exposure and Prevention of Bronchopulmonary Dysplasia in Premature Infants
Furosemide Exposure and Prevention of Bronchopulmonary Dysplasia in Premature Infants
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DOI：
10.1016/j.jpeds.2018.11.043
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发表时间：
2019-05-01
影响因子：
5.1
通讯作者：
Smith，P. Brian
中科院分区：
文献类型：
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作者：
Greenberg，Rachel G.;Gayam，Sreepriya;Smith，P. Brian
目的评估呋塞米暴露与支气管肺发育不良（BPD）风险之间的关系。研究设计本回顾性队列研究纳入了2004-2015年出生于胎龄23-29周、出生体重501-1249 g的婴儿。我们比较了出生后第7天和月经后第36周暴露于和未暴露于呋塞米的婴儿的人口统计学和临床特征。我们研究了呋塞米暴露与2种结局之间的关系：BPD和BPD或死亡。我们进行了多变量的概率回归模型，包括人口和临床变量，除了2个工具变量：呋塞米暴露出院年，呋塞米暴露site.ResultsOf 37 693包括婴儿，19 235（51%）暴露于呋塞米，这些婴儿更早产，有较高的呼吸支持。在33760名存活至BPD评估的婴儿中，15954名（47%）患有BPD。呋塞米暴露天数比例增加10个百分点与BPD（4.6个百分点;P= 0.001）和BPD或死亡（3.7个百分点;P= 0.01）的发病率下降有关。
ObjectiveTo evaluate the association between furosemide exposure and risk of bronchopulmonary dysplasia (BPD).Study designThis retrospective cohort study included infants (2004-2015) born at 23-29 weeks gestational age and 501-1249 g birth weight. We compared the demographic and clinical characteristics of infants exposed and not exposed to furosemide between postnatal day 7 and 36 weeks postmenstrual age. We examined the association between furosemide exposure and 2 outcomes: BPD and BPD or death. We performed multivariable probit regression models that included demographic and clinical variables in addition to 2 instrumental variables: furosemide exposure by discharge year, and furosemide exposure by site.ResultsOf 37 693 included infants, 19 235 (51%) were exposed to furosemide; these infants were more premature and had higher respiratory support. Of 33 760 infants who survived to BPD evaluation, 15 954 (47%) had BPD. An increase in the proportion of furosemide exposure days by 10 percentage points was associated with a decrease in both the incidence of BPD (4.6 percentage points;P= .001), and BPD or death (3.7 percentage points;P= .01).ConclusionsMore days of furosemide exposure between postnatal day 7 and 36 weeks was associated with decreased risk of BPD and a combined outcome of BPD or death.