Effect of Inhaled Furosernide in Acute Asthma

We assessed the acute bronchodilator effect of nebulized furosemide when added to conventional therapy of acute emergency department (ED) asthma. Using a double-blind design, 42 patients with acute asthma were randomized to receive 2.5 mg nebulized salbutamol and either 40 mg of nebulized furosemide or saline solution. We recorded clinical variables (respiratory rate, heart rate, and pulsus paradoxus) and peak expiratory flow rates (PEFR) before and 15 and 30 min after therapy. We found no significant difference in PEFR between salbutamoVfurosemide and salbutamol/saline-treated patients 15 and 30 min following inhalation. Other endpoints were equally unaffected. However, when we examined separately those patients whose exacerbations were of relative short duration (<8 hr), PEFR improved significantly more in the furosemidetreated group. At 15 min, PEFR increased by 82 k 48% in the furosemide group compared to 35 k 40% in the control group (p = 0.03), an effect that was also evident at 30 min when PEFR had increased by 113 f 49% in the furosemide group versus 61 k 35% in the control group (p = 0.014). Respiratory rate, heart rate, and pulsus paradoxus improved with no differences between the groups. The beneficial effect of furosemide was not evident in patients who reported