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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Variation in the Use of Diuretic Therapy for Infants With Bronchopulmonary Dysplasia
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Variation in the Use of Diuretic Therapy for Infants With Bronchopulmonary Dysplasia

机译：婴幼儿支气管肺发育不良的利尿治疗方法的变化

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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.
机译：目的：确定（1）支气管肺发育不良（BPD）婴儿的利尿剂使用情况在医院之间的差异，包括医院特定的治疗频率，治疗时间以及接受短时间（<= 5天连续）而接受较长时间（> 5天）课程，并确定（2）与利尿剂给药相关的人口统计学和临床​​变量。方法：使用儿科健康信息系统进行了一项回顾性队列研究，以确定在<29周龄BPD发生发展的婴儿中，利尿剂利用模式（主要结局）的医院间差异以及与利尿剂使用相关的变量结果：在2007年1月至2011年6月之间出院的28天。结果：在54个月的研究期内，共有35家医院的1429例婴儿在28天时符合BPD纳入标准，其中1222例婴儿（86％）接受利尿治疗9天（25-75％百分数：2-33天）。对1203名（83％）婴儿进行了短期疗程，而570名（40％）婴儿接受了连续5天以上的治疗。速尿是最广泛使用的利尿剂（1218例婴儿; 85％），尽管氯噻嗪的中位使用时间最长（21天; 25-75％百分位数：8-46天）。接受利尿疗程超过5天的婴儿的范围因医院而异，从4％到86％不等，即使在对混杂变量进行调整后，院内差异也很大。结论：美国儿童BPD婴儿使用利尿剂的频率医院以及所使用的具体利尿方案因机构而异。 BPD患者长期利尿剂治疗的安全性和有效性研究需要制定循证推荐。

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