The Adjunctive Effect of Nebulized Furosemide in COPD Exacerbation: A Randomized Controlled Clinical Trial

Vahedi, H; Mahshidfar, Babak; Rabiee, Helaleh; Saadat, Soheil; Shokoohi, Hamid; Chardoli, Mojtaba; Rahimi‐Movaghar, Vafa

doi:10.4187/respcare.02160

Cited by 31 publications

(24 citation statements)

References 24 publications

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“…In a randomized double-blinded clinical trial the effect of nebulized furosemide (40 mg) as an adjunct to conventional treatment has been tested in the emergency department on 100 AECOPD patients [ 158 ]. Changes in dyspnea perception, FEV 1 , arterial blood gas variables, blood pressure, breathing frequency, and heart rate at baseline and at 1 h were the study measurements.…”

Section: Non-conventional Drugsmentioning

confidence: 99%

Management of severe acute exacerbations of COPD: an updated narrative review

Crisafulli

Barbeta

Ielpo

et al. 2018

Multidiscip Respir Med

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BackgroundPatients with chronic obstructive pulmonary disease (COPD) may experience an acute worsening of respiratory symptoms that results in additional therapy; this event is defined as a COPD exacerbation (AECOPD). Hospitalization for AECOPD is accompanied by a rapid decline in health status with a high risk of mortality or other negative outcomes such as need for endotracheal intubation or intensive care unit (ICU) admission. Treatments for AECOPD aim to minimize the negative impact of the current exacerbation and to prevent subsequent events, such as relapse or readmission to hospital.Main bodyIn this narrative review, we update the scientific evidence about the in-hospital pharmacological and non-pharmacological treatments used in the management of a severe AECOPD. We review inhaled bronchodilators, steroids, and antibiotics for the pharmacological approach, and oxygen, high flow nasal cannulae (HFNC) oxygen therapy, non-invasive mechanical ventilation (NIMV) and pulmonary rehabilitation (PR) as non-pharmacological treatments. We also review some studies of non-conventional drugs that have been proposed for severe AECOPD.ConclusionSeveral treatments exist for severe AECOPD patients requiring hospitalization. Some treatments such as steroids and NIMV (in patients admitted with a hypercapnic acute respiratory failure and respiratory acidosis) are supported by strong evidence of their efficacy. HFNC oxygen therapy needs further prospective studies. Although antibiotics are preferred in ICU patients, there is a lack of evidence regarding the preferred drugs and optimal duration of treatment for non-ICU patients. Early rehabilitation, if associated with standard treatment of patients, is recommended due to its feasibility and safety. There are currently few promising new drugs or new applications of existing drugs.

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Section: Non-conventional Drugsmentioning

confidence: 99%

Management of severe acute exacerbations of COPD: an updated narrative review

Crisafulli

Barbeta

Ielpo

et al. 2018

Multidiscip Respir Med

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“…When given alongside initial 'standard' treatment for an exacerbation of COPD, nebulized furosemide results in additional improvement in breathlessness and various respiratory parameters. 31 However, it does not have an established role in this setting.…”

Section: Drug Interactionsmentioning

confidence: 99%

Furosemide

Carone

Oxberry

Twycross

et al. 2016

Journal of Pain and Symptom Management

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Therapeutic Reviews aim to provide essential independent information for health professionals about drugs used in palliative and hospice care. Additional content is available on www.palliativedrugs.com. Country-specific books (Hospice and Palliative Care Formulary USA, and Palliative Care Formulary, British and Canadian editions) are also available and can be ordered from www.palliativedrugs.com. The series editors welcome feedback on the articles (hq@palliativedrugs.com).

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“…Diferentes revisiones de los efectos de la furosemida nebulizada en los pacientes con obstrucción de la vía aérea han encontrado que tiene un leve efecto broncodilatador, o al menos es capaz de detener la broncoconstricción 134 . Un reciente ensayo clínico aleatorizado de 100 pacientes con exacerbación de EPOC, comparando con añadir furosemida inhalada al tratamiento convencional, encuentra una mejoría significativa del FEV 1 , la disnea, el pH, la presión arterial y la frecuencia cardiaca en el grupo de la furosemida 135 .…”

Section: Otras Terapias Nebulizadas (Tabla 2)unclassified