A Randomized Controlled Trial of a Single Dose Furosemide to Improve Respiratory Distress in Moderate to Severe Bronchiolitis
Publication Date
2018
Journal Title
J Emerg Med
Abstract
© 2017 Elsevier Inc. Background Bronchiolitis is one of the most common disorders of the lower respiratory tract in infants. While historically diuretics have been used in severe bronchiolitis, no studies have looked directly at their early use in children in the emergency department. Objective The primary objective of this study was to determine whether a single early dose of a diuretic in infants with moderate to severe bronchiolitis would improve respiratory distress. Secondary objectives examined whether it reduced the use of noninvasive ventilation and hospital length of stay. Methods Patients diagnosed with clinical bronchiolitis were enrolled at a tertiary care, academic children's hospital over a 3-year period. This was a double-blind, randomized controlled trial in which subjects were randomly assigned to either furosemide or placebo. Respiratory rate and oxygen saturation at the time of medication delivery and at 2 and 4 h post-intervention were recorded, as well as other data. Exact logistic regression was used to examine associations. Results There were 46 subjects enrolled and randomized. There was no difference in respiratory rates, measured as a decrease of ≥ 25%, at both 2 and 4 h after intervention between furosemide and placebo groups (odds ratios 1.13 and 1.13, respectively). There was also no difference in oxygen saturation, intensive care unit admission rate, or hospital length of stay between groups. Conclusions While theoretically a single dose of a diuretic to reduce lung fluid would improve respiratory distress in children with bronchiolitis, our randomized controlled medication trial showed no difference in outcomes. ClinicalTrials.gov ID: NCT02469597.
Volume Number
54
Issue Number
1
Pages
40 - 46
Document Type
Article
Status
Faculty
Facility
School of Medicine
Primary Department
General Pediatrics
Additional Departments
Emergency Medicine; Science Education
PMID
DOI
10.1016/j.jemermed.2017.08.099