First name
Heather
Middle name
M
Last name
Monk

Title

The association between diuretic class exposures and enteral electrolyte use in infants developing grade 2 or 3 bronchopulmonary dysplasia in United States children's hospitals.

Year of Publication

2021

Date Published

2021 Jan 28

ISSN Number

1476-5543

Abstract

<p><strong>OBJECTIVE: </strong>To evaluate the association between chronic diuretic exposures and enteral electrolyte use in infants developing severe bronchopulmonary dysplasia (sBPD).</p>

<p><strong>STUDY DESIGN: </strong>Retrospective longitudinal cohort study in infants admitted to United States children's hospitals. We identified diuretic exposures and measured enteral NaCl and KCl use during pre-defined exposure risk-interval days. We used mixed-effects logistic regression to model the association between diuretic exposures and electrolyte use.</p>

<p><strong>RESULTS: </strong>We identified 442,341 subject-days in 3252 infants. All common diuretic classes and class combinations were associated with increased NaCl and KCl use. Thiazide monotherapy was associated with greater electrolyte use than loop monotherapy. The addition of potassium-sparing diuretics was associated with a limited reduction in KCl use compared to thiazide monotherapy.</p>

<p><strong>CONCLUSIONS: </strong>Chronic diuretic exposures are associated with increased NaCl and KCl use. Presumptions about the relative impact of different diuretic classes on electrolyte derangements may be inaccurate and require further study.</p>

DOI

10.1038/s41372-021-00924-y

Alternate Title

J Perinatol

PMID

33510422

Title

Medication use in infants with severe bronchopulmonary dysplasia admitted to United States children's hospitals.

Year of Publication

2019

Date Published

2019 Jun 21

ISSN Number

1476-5543

Abstract

<p><strong>OBJECTIVE: </strong>To identify the number of cumulative medication exposures and most frequently used medications in infants with severe BPD.</p>

<p><strong>STUDY DESIGN: </strong>We performed a retrospective cohort study in infants with severe BPD admitted to United States children's hospitals. We measured cumulative medication exposures in individual subjects and between-center variation after adjustment for infant characteristics. We then identified the specific medications and therapeutic classes with the highest rates of use.</p>

<p><strong>RESULTS: </strong>In 3252 subjects across 43 hospitals, we identified a median (interquartile range) of 30 (17-45) cumulative medication exposures per infant. The adjusted mean number of medication exposures varied between centers (p &lt; 0.0001), with a range of 22-50. Diuretics and furosemide were the most frequently prescribed therapeutic class and specific medication for the management of severe BPD.</p>

<p><strong>CONCLUSIONS: </strong>Infants with severe BPD are exposed to alarming number of medications of unclear efficacy and safety, with marked variation between center.</p>

DOI

10.1038/s41372-019-0415-9

Alternate Title

J Perinatol

PMID

31227785

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