Inhaled furosemide in hospitalized infants with viral bronchiolitis: a randomized, double-blind, placebo-controlled pilot study.
OBJECTIVE
To evaluate the short and long-term clinical effects and the treatment-feasibility of inhaled-furosemide (IF) as compared with placebo via hood in hospitalized infants with viral-bronchiolitis (VB).


METHODS
A randomized, double-blind, placebo-controlled pilot-study was performed in previously healthy infants (0-12 months). Enrolled infants were randomized to receive either IF (2 mg/kg), or placebo nebulized by hood three times daily throughout the hospitalization. Clinical assessment (respiratory distress assessment instrument [RDAI]) was performed before, 30 and 60 min after the 1st daily inhalation. The short-term effects were evaluated by the RDAI, respiratory assessment change score (RACS) and oxygen requirement and the long-term effects by time to be weaned off oxygen, time to full enteral feeding, length of stay, and "ready to discharge" time.


RESULTS
Both groups (16 infants each) had comparable characteristics at study entry. Mean (+/-SD) age was 72 +/- 43 days, and 29/32 infants were RSV positive. Oxygen requirement (FiO(2)) decreased significantly at 30 min post-inhalation (30 +/- 9.2% to 26 +/- 7.1%, P < 0.05) only in the IF group. RACSs and long-term effects of both groups were comparable. Analysis of IF particles generated by the hood-nebulizer demonstrated that 36% and 49% of the particles were <3 and 5 microm, respectively. No side effects were observed during IF treatment.


CONCLUSIONS
Based on our pilot study, IF has no significant clinical effects in hospitalized infants with VB. IF via hood seems to be feasible and safe.
Bar
Amir
A
Department of Pediatrics, Bnai Zion Medical Center, The Bruce Rappaport Faculty of Medicine, Haifa, Israel.
Srugo
Isaac
I
Amirav
Israel
I
Tzverling
Chana
C
Naftali
Gabi
G
Kugelman
Amir
A
D001990:Bronchiolitis, Viral / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009330:Nebulizers and Vaporizers; D010865:Pilot Projects; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
D049994:Sodium Potassium Chloride Symporter Inhibitors; D005665:Furosemide