Effectiveness of nebulized furosemide added to nebulized salbutamol in children with acute asthma.

BACKGROUND Nebulized furosemide has been shown to be protective against bronchoconstricting stimuli. METHODS To investigate whether inhaled furosemide would exhibit an additional therapeutic effect in children with acute asthma we performed a double-blind, placebo-controlled study in which patients with acute asthma attack were randomized to receive either nebulized salbutamol (0.15 mg/kg) plus nebulized furosemide (10 mg/m(2)) or nebulized salbutamol (0.15 mg/kg) plus nebulized saline as placebo. In all patients, clinical asthma scores (CAS) were determined before and after drug administration. Peak expiratory flow rates (PEFR) were measured by a peak flow meter. RESULTS CAS and PEFR improved in both groups with nebulized salbutamol treatment. The CAS changed from 3.56 +/- 2.13 to 2.06 +/- 1.84 (p = 0.0001) in the study group and from 4.44 +/- 2.63 to 2.56 +/- 1.86 (p = 0.0003) in the control group. PEFR increased from 177.50 +/- 65.88 to 221.88 +/- 66.05 L/min in the first group (p = 0.0001) and from 183.13 +/- 51.73 to 218.13 +/- 60.25 in the second group (p = 0.0001). CONCLUSION Adding nebulized furosemide to nebulized salbutamol in pediatric patients experiencing an acute asthma attack did not produce greater improvement in clinical (p = 0.3829) or spirometric (p = 0.3839) parameters than nebulized salbutamol alone.