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Lung Ultrasound Assessment of Pulmonary Edema in Neonates with Chronic Lung Disease Before and After Diuretic Therapy
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  • Dalibor Kurepa,
  • Gangajal Kasniya,
  • Jane Cerise,
  • Margaret Pulju,
  • Vitaliya Boyar,
  • Florin Frunza,
  • Barry Weinberger
Dalibor Kurepa
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Gangajal Kasniya
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Jane Cerise
no affiliation
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Margaret Pulju
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Vitaliya Boyar
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Florin Frunza
no affiliation
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Barry Weinberger
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Abstract

Introduction: Bronchopulmonary dysplasia (BPD) is characterized by lung injury with varying degrees of disrupted alveolarization, vascular remodeling, inflammatory cell proliferation, and pulmonary edema. Diuretics are often used to ameliorate the symptoms or progression of BPD. Our primary objective was to use lung ultrasound (LUS) to determine if diuretics decrease pulmonary edema in infants with BPD. The secondary objective was to assess changes in respiratory support during the first week after initiation of diuretics. Methods: Premature infants requiring non-invasive respiratory support and starting diuretic therapy for evolving BPD were compared with a similar group of infants not receiving diuretics (control). For the diuretic group, LUS exams were performed before and on days 1, 3 and 6 after initiation of treatment. For the control group, LUS was performed at equivalent time points. A composite pulmonary edema severity (PES) score of 0 to 5 was calculated based on the total number of B-lines in 6 scanned areas. Respiratory support parameters (FiO2, nasal cannula flow or CPAP) were also recorded. Results: Infants in the diuretic (n=28) and control (n=23) groups were recruited at median corrected gestational ages of 34.2 (33.3-35.9) and 34.0 (33.4-36.3) weeks, respectively ( p=0.82). PES scores, FiO2, and respiratory flow support decreased significantly from day 0 to 6 ( p<.0001, p=0.001, and p=0.01, respectively) in the diuretic group, but not in the control group. Conclusion: Diuretic use is associated with decreased pulmonary edema and improved oxygenation in infants with BPD during the first week of treatment.
12 Aug 2022Submitted to Pediatric Pulmonology
12 Aug 2022Assigned to Editor
12 Aug 2022Submission Checks Completed
14 Aug 2022Reviewer(s) Assigned
06 Sep 2022Review(s) Completed, Editorial Evaluation Pending
09 Sep 2022Editorial Decision: Accept