Furosemide infusion in children with dengue fever and hypoxemia

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Pulmonology

Background:

• Acute respiratory distress syndrome (ARDS) is a severe complication of dengue fever.
• Management of dengue-associated ARDS often involves mechanical ventilation.
• The role of diuretic therapy in this context requires further investigation.

Purpose of the Study:

• To evaluate the efficacy of furosemide infusion in managing ARDS in children with dengue fever.
• To compare outcomes between diuretic therapy alone, combined therapy (diuretics and ventilation), and ventilation alone.

Main Methods:

• A study involving pediatric patients (1 month to 18 years) diagnosed with dengue and ARDS.
• Patients were divided into three groups: diuretic therapy alone (Group D), diuretics plus ventilation (Group B), and ventilation alone (historical control, Group V).
• Furosemide infusion was administered at 0.05-0.1 mg/kg/hour for 48 hours, aiming for a specific urine output.

Main Results:

• Significant differences in survival rates were observed across the three groups.
• Post-intervention arterial blood gas parameters, including PCO2, pO2, PaO2/FaO2 ratio, and alveolar-arteriolar oxygen gradient, showed significant improvements.
• These findings suggest a positive impact of furosemide infusion on respiratory parameters.

Conclusions:

• Furosemide infusion demonstrates a beneficial role in improving outcomes for patients with dengue-associated ARDS.
• The study supports the integration of diuretic therapy into the management protocols for severe dengue complications.
• Further research may explore optimal dosing and patient selection for diuretic therapy in ARDS.