Spontaneous Diuresis in Premature Infants with Hyaline Membrane Disease

To study spontaneous diuresis in premature infants with hyaline membrane disease (HMD), a total of 46 cases was classified into three groups: Group 1, infants with HMD, weighing＞1,500 grams; Group 2, infants with HMD, weighing ≤1,500 grams; and Group 3, infants without HMD, weighing ≤1,500 grams. Comparisons of Group 1 with Group 2 and Group 2 with Group 3 were made to assess the influence of birth weight and of HMD itself on spontaneous diuresis. All the premature infants with or without HMD had an onset of spontaneous diuresis at about 30 to 36 hours of postnatal age. Group 1, with more cases delivered by Caesarean section, had longer duration of diuresis and less body weight loss at Day five than Group 2, whereas Group 2 had diuresis of longer duration and more weight loss at Day five than Group 3. Significant improvement in inspired fraction of oxygen concentration (FiO2), alveolar-arterial oxygen difference (A-aDO2), and mean airway pressure (MAP) occured at 56 to 72 hours after the onset of diuresis in Groups 1 and 2. Sudden elevation of arterial oxygen tension (PaO2) to above 100 mmHg within 16 hours after onset of diuresis occurred frequently in Group 1, but not in Group 2. This study demonstrated that infants with HMD weighing＞1,500 grams had a longer duration of diuresis, which could be a reflection of more body water content. Administration of furosemide could possibly facilitate the recovery of these patients. Since pulmonary function improved gradually following diuresis, the enhancement of insensible water loss in anticipation of the onset of diuresis is speculated to be a potentially effective method for accelerating recovery of infants with HMD.