Dataset Information

Nebulized Furosemide for Pulmonary Inflammation in Intubated Patients With COVID-19: A Phase 2 Randomized Controlled Double-Blind Study.

ABSTRACT:

Objectives

Respiratory failure secondary to COVID-19 is associated with morbidity and mortality. Current anti-inflammatory therapies are effective but are given systemically and have significant side effects. Furosemide has anti-inflammatory properties, can be administered by inhalation, and is inexpensive. We investigated the efficacy of nebulized furosemide as an adjunctive therapy for COVID-19 respiratory failure.

Design

A double-blind, randomized, placebo-controlled trial.

Setting

Multicenter ICU study.

Patients

Adults requiring invasive mechanical ventilation secondary to COVID-19.

Intervention

Patients were randomized within 48 hours of intubation to receive inhaled furosemide or placebo until day 28, death, or liberation from mechanical ventilation.

Measurements and main results

The study was stopped early due to waning incidence of COVID-19; 39 patients were available for analysis with mean ± sd age of 70.5 (10.8) years, Acute Physiology and Chronic Health Evaluation II 26.1 (7.8) and Fio₂ 60.0% (21.9). Baseline characteristics were similar between the groups. For the primary outcome of change in Pao₂/Fio₂ ratio between day 1 and day 6, it was +31.4 (83.5) in the furosemide arm versus +20.1 (92.8) in the control (p = 0.58). For secondary outcomes, furosemide versus control: 60-day mortality was 48% versus 71% (p = 0.20), hospital stay was 25.6 (21.9) versus 27.4 (25.0) days, p = 0.94 and VFD was 6.0 (9.1) versus 3.1 (7.1), p value of equals to 0.28. A post hoc analysis of the hierarchical composite outcome, alive and ventilator-free favored furosemide. There were no adverse events.

Conclusions

In this trial of inhaled furosemide for COVID-19 respiratory failure, differences in Pao₂/Fio₂ ratio to day 6 and other clinical outcomes were not significantly different, although the trial was underpowered due to early termination. Given the favorable profile of inhaled furosemide, further study is warranted in disease states where acute pulmonary inflammation contributes to the underlying pathophysiology.

SUBMITTER: Muscedere J

PROVIDER: S-EPMC10954058 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Nebulized Furosemide for Pulmonary Inflammation in Intubated Patients With COVID-19: A Phase 2 Randomized Controlled Double-Blind Study.

Muscedere John J Maslove David M DM Barden Christopher J CJ Weaver Donald F DF Boyd J Gordon JG Sibley Stephanie S Boyd Tracy T Rewa Oleksa O Albert Martin M Roussos Marios M Norman Patrick A PA Day Andrew G AG

Critical care explorations 20240202 2

<h4>Objectives</h4>Respiratory failure secondary to COVID-19 is associated with morbidity and mortality. Current anti-inflammatory therapies are effective but are given systemically and have significant side effects. Furosemide has anti-inflammatory properties, can be administered by inhalation, and is inexpensive. We investigated the efficacy of nebulized furosemide as an adjunctive therapy for COVID-19 respiratory failure.<h4>Design</h4>A double-blind, randomized, placebo-controlled trial.<h4> ...[more]

PMID: 38511126

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Dataset Information

Nebulized Furosemide for Pulmonary Inflammation in Intubated Patients With COVID-19: A Phase 2 Randomized Controlled Double-Blind Study.

Objectives

Design

Setting

Patients

Intervention

Measurements and main results

Conclusions

Publications

Nebulized Furosemide for Pulmonary Inflammation in Intubated Patients With COVID-19: A Phase 2 Randomized Controlled Double-Blind Study.

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