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The effect of aerosolized furosemide in infants with chronic lung disease
1Department of Paediatrics, Gunma University School of Medicine, Maebashi, Japan.
Insights
Aerosolized furosemide significantly improved pulmonary function, including static respiratory compliance and tidal volume, in premature infants with chronic lung disease. This treatment did not cause excessive diuresis, offering a potential benefit for these vulnerable infants.
Area of Science:
- Pediatrics
- Neonatology
- Pulmonology
Background:
- Chronic lung disease (CLD) is a common complication in premature infants requiring mechanical ventilation.
- Pulmonary function deficits in CLD contribute to significant morbidity and mortality.
- Pharmacological interventions to improve lung function in these infants are actively sought.
Purpose of the Study:
- To evaluate the efficacy of aerosolized furosemide in improving pulmonary function in preterm infants with CLD.
- To assess the impact of aerosolized furosemide on static respiratory compliance, tidal volume, and respiratory resistance.
- To determine if aerosolized furosemide causes significant diuresis in this population.
Main Methods:
- A randomized, double-blind, placebo-controlled, cross-over trial was conducted.
- Eight ventilator-dependent preterm infants with CLD received either aerosolized furosemide (2 mg/kg) or placebo (0.9% saline).
- Pulmonary function tests were performed serially before and up to 2 hours after inhalation.
Main Results:
- Aerosolized furosemide significantly increased static respiratory compliance by 24.3% and 23.2% at 1 and 2 hours post-inhalation (p=0.014, p=0.022).
- Tidal volume showed significant increases of 33.8% and 28.7% at 1 and 2 hours after furosemide (p=0.004, p=0.009).
- No significant changes in total respiratory resistance or urine volume were observed with furosemide compared to placebo.
Conclusions:
- Aerosolized furosemide is effective in improving key pulmonary mechanics in preterm infants with CLD.
- The observed improvements in lung function occur without significant adverse effects like excessive diuresis.
- Aerosolized furosemide represents a promising therapeutic option for managing pulmonary dysfunction in ventilator-dependent premature infants with CLD.
Abstract:
To investigate whether aerosolized furosemide would improve pulmonary function in premature infants with chronic lung disease, we enrolled eight preterm ventilator-dependent infants in a cross-over, double-blind, placebo-controlled trial. Either aerosolized furosemide (2 mg/kg) or placebo (0.9% saline) was administered, and serial pulmonary function tests were performed before and at 1 and 2 h after each inhalation. After furosemide inhalation, static respiratory compliance increased significantly by 24.3% and 23.2% as percentage change from the baseline value at 1 and 2 h (p = 0.014 and 0.022, respectively). Also, tidal volume increased significantly by 33.8% and 28.7% at 1 and 2 h, respectively (p = 0.004 and 0.009). In contrast, no changes were observed in them after placebo inhalation. Total respiratory resistance was unchanged after both furosemide and placebo inhalation. There were no differences in urine volume in two groups. These data suggested that aerosolized furosemide improved pulmonary function in infants with chronic lung disease without excessive diuresis.