SHORT-TERM AND LONG-TERM EFFECTS OF FUROSEMIDE ON LUNG-FUNCTION IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA
SHORT-TERM AND LONG-TERM EFFECTS OF FUROSEMIDE ON LUNG-FUNCTION IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA
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DOI：
10.1016/s0022-3476(86)80295-5
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发表时间：
1986-12-01
影响因子：
5.1
通讯作者：
HAZINSKI, TA
中科院分区：
文献类型：
--
作者：
ENGELHARDT, B;ELLIOTT, S;HAZINSKI, TA
虽然呋塞米改善了某些支气管肺发育不良（BPD）婴儿的肺力学，但除非气体交换也得到改善，否则这可能并不重要。为了确定力学改善和气体交换改善之间的关系，在16名患有严重BPD的自主呼吸婴儿中研究了呋塞米治疗的短期和长期效果，这些婴儿既依赖氧又高碳水化合物（平均PCO254 ± 0.001）。11日）。每个婴儿至少接受三次检查：速尿治疗前、第一剂速尿后1小时以及6至10天疗程后。在为期7天的对照期内，16名婴儿中有10名还接受了三次检查。测量经皮PO2和PCO2、食管压力、气流和潮气量。计算肺阻力、肺顺应性和肺泡与皮肤的PO2差。单剂量呋塞米后，只有依从性显著改善。经过长期治疗，整个组的依从性、阻力和氧合显著改善，但16名婴儿中只有6名获得了更好的氧合。tcPCO2不受长期呋塞米治疗的影响，但在所有单次给药后1小时tcPCO2降低的婴儿中，延长治疗后PCO2持续降低。气体交换的变化不能用肺力学的变化来解释。这些数据表明，长期利尿剂治疗可以改善自发呼吸的BPD婴儿的肺机械性能，但气体交换通常不受影响。
Although furosemide improves lung mechanics in some infants with bronchopulmonary dysplasia (BPD), this may not be important unless gas exchange also improves. To determine the relationship between improvement in mechanics and improvement in gas exchange, the short- and long-term effects of furosemide therapy were studied in 16 spontaneously breathing infants with severe BPD who were both oxygen dependent and hypercarbic (mean PCO254 .+-. 11 torr). Each infant was examined at least three times: before furosemide therapy, 1 hour after the first dose of furosemide, and after a 6- to 10-day course. Ten of the 16 infants were also examined three times during a 7-day control period. Transcutaneous PO2 and PCO2, esophageal pressure, air flow, and tidal volume were measured. Pulmonary resistance, lung compliance, and the alveolar to skin PO2 difference were calculated. After a single dose of furosemide, only compliance significantly improved. After prolonged therapy, compliance, resistance, and oxygenation significantly improved in the group as a whole, but better oxygenation was achieved in only 6 of 16 infants. tcPCO2 was unaffected by long-term furosemide therapy, but in all infants with decreased tcPCO2 1 hour after a single dose, there was sustained decrease in PCO2 after prolonged therapy. Changes in gas exchange were not explained by changes in lung mechanics. These data indicate that long-term diuretic therapy can improve the mechanical properties of the lungs of spontaneously breathing infants with BPD, but that gas exchange is usually unaffected.