Diuresis and respiratory distress syndrome:Physiologic mechanisms and therapeutic implications

William D. Engle, Billy S. Arant, Suvipa Wiriyathian, Charles R. Rosenfeld

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Previous studies have suggested that spontaneous diuresis may be important to the recovery fromrespiratory distress syndrome in preterm infants. Daily quantification of fluid intake (I) and urine output (O) were recorded, and O/I and alveolar-arterial oxygen gradients (AaDO2) were determined for sequential eight-hour periods in 10 inborn premature infants with RDS. Sequential timed-urine-plasma collections were obtained during the first four days of life to evaluate the role of hormonal and vasoactive factors in the acute phase of RDS. Diuresis (O/I>0.80) occurred at 25 to 32 hours, preceded any significant improvement in AaDO2 (which occurred at 57 to 64 hours), and was associated with a 6.2±1.4% decrease in body weight. Although there was no significant change in glomerular filtration rate, plasma AVP concentrations, or urinary excretion of AVP in the infants, there were significant decreases in both plasma concentrations and urinary excretion of 6-keto-PGF (stable metabolite of prostacyclin) in sequential studies. These results suggest that changes in renal function or AVP may not be of primary importance in the diuresis associated with RDS, and that decreasing levels of prostacyclin, a prostaglandin that increases vascular permeability and lowers blood pressure, may have an important physiologic role.

Original languageEnglish (US)
Pages (from-to)912-917
Number of pages6
JournalThe Journal of Pediatrics
Issue number6
StatePublished - Jun 1983

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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