PT - JOURNAL ARTICLE AU - Hojat Sheikh Motahar Vahedi AU - Babak Mahshidfar AU - Helaleh Rabiee AU - Soheil Saadat AU - Hamid Shokoohi AU - Mojtaba Chardoli AU - Vafa Rahimi-Movaghar TI - The Adjunctive Effect of Nebulized Furosemide in Acute Treatment of Patients with Chronic Obstructive Pulmonary Disease Exacerbation: A Randomized Controlled Clinical Trial AID - 10.4187/respcare.02160 DP - 2013 Apr 30 TA - Respiratory Care PG - respcare.02160 4099 - http://rc.rcjournal.com/content/early/2013/04/30/respcare.02160.short 4100 - http://rc.rcjournal.com/content/early/2013/04/30/respcare.02160.full AB - Objective: To examine the effect of nebulized furosemide as an adjunct to the conventional treatment of patients with chronic obstructive pulmonary disease (COPD) exacerbation in an emergency department. Method: In this randomized double-blinded clinical trial, patients with the clinical presentation of COPD exacerbation were randomized to receive 40 mg nebulized furosemide (intervention group) or placebo (control group) as an adjunct to their conventional treatments. Changes in the severity of dyspnea (dyspnea-Visual Analog Scale), Forced Expiratory Volume in one second (FEV1), arterial blood gas (ABG) measurements, blood pressure, pulse rate and respiratory rate were assessed at the baseline and compared in the two groups, one hour after the treatment. Result: One hundred COPD patients with the mean age of 73.1± 8.7 were randomized. Clinical parameters including the severity of dyspnea and FEV1 improved significantly after both therapies, whereas higher FEV1 and lower severity of dyspnea were observed in the furosemide group compared to the placebo group (p<0.001). In addition, patients treated with nebulized furosemide yielded a significant elevation in the mean pH and Pao2 an hour after the treatment (p<0.001). There was a significant decrease in the mean blood pressure and pulse rate in the furosemide group compared with the placebo. Conclusion: Nebulized furosemide as an adjunctive to the conventional treatment demonstrated additional clinical benefits for acute management of patients with COPD exacerbation. This may provide an additional therapeutic option in treatment of patients with COPD exacerbation.