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. 2011 Dec 7;2011(12):CD001454. doi: 10.1002/14651858.CD001454.pub3

Comparison 1. Routine diuretic administration versus placebo, no treatment or PRN diuretic administration.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Death 6   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.1 All 6 248 Risk Ratio (M‐H, Fixed, 95% CI) 1.35 [0.71, 2.56]
1.2 Postnatal age < 24 hours 4 167 Risk Ratio (M‐H, Fixed, 95% CI) 1.47 [0.72, 2.97]
1.3 Postnatal age at least 24 hours 2 81 Risk Ratio (M‐H, Fixed, 95% CI) 0.97 [0.21, 4.48]
1.4 Loop diuretics 5 198 Risk Ratio (M‐H, Fixed, 95% CI) 1.30 [0.67, 2.52]
1.5 Theophylline 1 50 Risk Ratio (M‐H, Fixed, 95% CI) 2.0 [0.19, 20.67]
1.6 Sensitivity 5 228 Risk Ratio (M‐H, Fixed, 95% CI) 1.07 [0.51, 2.24]
2 Clinically significant PDA 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.1 All 4 208 Risk Ratio (M‐H, Fixed, 95% CI) 1.11 [0.72, 1.71]
2.2 Postnatal age < 24 hours 3 139 Risk Ratio (M‐H, Fixed, 95% CI) 0.86 [0.50, 1.48]
2.3 Postnatal age at least 24 hours 1 69 Risk Ratio (M‐H, Fixed, 95% CI) 1.7 [0.82, 3.53]
2.4 Loop diuretics 3 161 Risk Ratio (M‐H, Fixed, 95% CI) 1.08 [0.67, 1.73]
2.5 Theophylline 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 1.25 [0.44, 3.54]
3 Hypovolemic shock 1 12 Risk Ratio (M‐H, Fixed, 95% CI) 4.0 [0.20, 82.01]
3.1 Postnatal age at least 24 hours 1 12 Risk Ratio (M‐H, Fixed, 95% CI) 4.0 [0.20, 82.01]
4 Change in plasma volume (ml/kg) from 48 to 96 hours of life 1 69 Mean Difference (IV, Fixed, 95% CI) ‐7.7 [‐11.74, ‐3.66]
4.1 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) ‐7.7 [‐11.74, ‐3.66]
5 Change in cardiovascular stability index from 48 to 96 hours of life 1 69 Mean Difference (IV, Fixed, 95% CI) 0.77 [‐0.14, 1.68]
5.1 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) 0.77 [‐0.14, 1.68]
6 Dobutamine infusion rate (micrograms/kg/min) at the end of treatment 1 69 Mean Difference (IV, Fixed, 95% CI) 3.10 [‐0.62, 6.82]
6.1 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) 3.10 [‐0.62, 6.82]
7 Dopamine infusion rate (micrograms/kg/min) at the end of treatment 1 69 Mean Difference (IV, Fixed, 95% CI) 2.41 [‐0.07, 4.89]
7.1 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) 2.41 [‐0.07, 4.89]
8 Change in colloid infusion rate (ml/kg/hour) at the end of treatment 1 69 Mean Difference (IV, Fixed, 95% CI) ‐0.86 [‐4.30, 2.58]
8.1 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) ‐0.86 [‐4.30, 2.58]
9 Failure to extubate within 3 days after study entry 1 56 Risk Ratio (M‐H, Fixed, 95% CI) 0.65 [0.45, 0.93]
9.1 Postnatal age < 24 hours 1 56 Risk Ratio (M‐H, Fixed, 95% CI) 0.65 [0.45, 0.93]
10 Change in peak inspiratory pressure (cm H2O) during treatment 1 36 Mean Difference (IV, Fixed, 95% CI) ‐6.62 [‐14.74, 1.50]
10.1 Postnatal age < 24 hours 1 36 Mean Difference (IV, Fixed, 95% CI) ‐6.62 [‐14.74, 1.50]
11 Change in mean airway pressure (cm H2O) during treatment 2 125 Mean Difference (IV, Fixed, 95% CI) ‐1.16 [‐2.42, 0.09]
11.1 Postnatal age < 24 hours 1 56 Mean Difference (IV, Fixed, 95% CI) ‐1.30 [‐2.81, 0.21]
11.2 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) ‐0.85 [‐3.11, 1.41]
12 Duration of mechanical ventilation (days) 2 105 Mean Difference (IV, Fixed, 95% CI) ‐2.83 [‐4.49, ‐1.17]
12.1 Postnatal age < 24 hours 1 36 Mean Difference (IV, Fixed, 95% CI) ‐5.0 [‐7.06, ‐2.94]
12.2 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) 1.20 [‐1.61, 4.01]
13 Change in FiO2 during treatment 2 92 Mean Difference (IV, Fixed, 95% CI) ‐0.05 [‐0.13, 0.03]
13.1 Postnatal age < 24 hours 2 92 Mean Difference (IV, Fixed, 95% CI) ‐0.05 [‐0.13, 0.03]
14 Change in alveolar‐arterial O2 gradient (mm Hg) during treatment 3 161 Mean Difference (IV, Fixed, 95% CI) ‐1.62 [‐43.75, 40.51]
14.1 Postnatal age < 24 hours 2 92 Mean Difference (IV, Fixed, 95% CI) ‐66.81 [‐131.24, ‐2.37]
14.2 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) 47.06 [‐8.62, 102.74]
15 BPD 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
15.1 All 3 139 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.41, 1.59]
15.2 Postnatal age < 24 hours 3 139 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.41, 1.59]
15.3 Loop diuretics 2 92 Risk Ratio (M‐H, Fixed, 95% CI) 1.02 [0.49, 2.10]
15.4 Theophylline 1 50 Risk Ratio (M‐H, Fixed, 95% CI) 0.29 [0.04, 2.44]
16 Death or BPD 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
16.1 All 2 87 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.32, 2.76]
16.2 Postnatal age <24 hours 2 87 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.32, 2.76]
16.3 Loop diuretics 1 37 Risk Ratio (M‐H, Fixed, 95% CI) 2.55 [0.29, 22.31]
16.4 Theophylline 1 50 Risk Ratio (M‐H, Fixed, 95% CI) 0.6 [0.16, 2.25]
17 Duration of oxygen supplementation (days) 3 161 Mean Difference (IV, Fixed, 95% CI) ‐0.50 [‐2.51, 1.50]
17.1 Postnatal age < 24 hours 2 92 Mean Difference (IV, Fixed, 95% CI) ‐0.22 [‐2.40, 1.96]
17.2 Postnatal age at least 24 hours 1 69 Mean Difference (IV, Fixed, 95% CI) ‐2.10 [‐7.28, 3.08]
18 IVH 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
18.1 All 3 127 Risk Ratio (M‐H, Fixed, 95% CI) 0.76 [0.40, 1.44]
18.2 Postnatal age < 24 hours 3 127 Risk Ratio (M‐H, Fixed, 95% CI) 0.76 [0.40, 1.44]
18.3 Loop diuretics 2 80 Risk Ratio (M‐H, Fixed, 95% CI) 0.90 [0.43, 1.88]
18.4 Theophylline 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 0.52 [0.15, 1.84]
18.5 Sensitivity 2 107 Risk Ratio (M‐H, Fixed, 95% CI) 0.63 [0.32, 1.26]
19 Severe IVH (grade III or IV) 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.07, 15.72]
19.1 All studies 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.07, 15.72]
20 Duration of hospitalization (days) 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
20.1 All 2 103 Mean Difference (IV, Fixed, 95% CI) 2.43 [‐10.71, 15.57]
20.2 Postnatal age < 24 hours 2 103 Mean Difference (IV, Fixed, 95% CI) 2.43 [‐10.71, 15.57]
20.3 Loop diuretics 1 56 Mean Difference (IV, Fixed, 95% CI) 6.60 [‐16.38, 29.58]
20.4 Theophylline 1 47 Mean Difference (IV, Fixed, 95% CI) 0.40 [‐15.62, 16.42]
21 Significant handicap at one year (major neurologic defect and/or MDI/PDI <50) 1 26 Risk Ratio (M‐H, Fixed, 95% CI) 0.43 [0.09, 1.94]
21.1 Postnatal age < 24 hours 1 26 Risk Ratio (M‐H, Fixed, 95% CI) 0.43 [0.09, 1.94]
22 Oligoanuria (urine output < 1 ml/kg/hour) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
22.1 All 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 0.13 [0.02, 0.96]
22.2 Theophylline 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 0.13 [0.02, 0.96]
23 Hyponatremia (sodium < 130 mM/L) 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.16, 6.80]
23.1 All 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.16, 6.80]
24 Hyperkalemia (potassium > 6.5 mM/L) 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 1.57 [0.29, 8.53]
24.1 All 1 47 Risk Ratio (M‐H, Fixed, 95% CI) 1.57 [0.29, 8.53]