Furosemide plus albuterol compared with albuterol alone in children with acute asthma

Several reports have shown that inhaled furosemide protects patients with asthma from different bronchoconstrictor agents. However, the effect of this widely used diuretic in acute exacerbation in adults is unproven. There are no reports of furosemide's therapeutic effect in acute asthma in children; thus, the objective of this study was to determine the effectiveness of the combined treatment of furosemide and albuterol in pediatric patients. Using a double-blind design, 20 emergency room patients with an asthmatic exacerbation were studied and randomly assigned to one of the following treatments: (1) furosemide + albuterol (1 and 0.15 mg/kg, respectively) or (2) albuterol (0.15 mg/kg). The forced expiratory volume in one second (FEV1) was measured in each patient before medication and then 30 and 60 minutes after inhalation of the individual drug or drug combination. Neither group differed in age or baseline FEV1. An increase in FEV1 of 22.8 +/- 4.3% (mean +/- SE) in the drug combination group was noted at 60 minutes, and an increase in FEV1 of 18.0 +/- 2.6% in the albuterol group was obtained at the same time. Although the increase in FEV1 was greater in the first group after 1 hour of treatment, this was not significant. These results suggest that inhaled furosemide does not have a synergistic effect with albuterol in the treatment of asthmatic exacerbations in children.