Jeba, J., George, R., & Pease, N. (2013). Nebulised furosemide in the palliation of dyspnoea in cancer: A systematic review. BMJ Supportive and Palliative Care, 4, 132–139. 

DOI Link

Purpose

STUDY PURPOSE: To review the evidence related to the effectiveness, the appropriate dose, and adverse effects of nebulized furosemide in patients with cancer
 
TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials database, and CINAHL
 
KEYWORDS: Neoplasms, dyspnea, breathlessness, furosemide, nebulizers, vaporizers, administration, and inhalation
 
INCLUSION CRITERIA: Randomized, controlled trials that compared nebulized furosemide with a placebo or control in which more than 80% of participants were over the age of 18. Nonrandomized prospective trials with samples greater than 30 were included. 
 
EXCLUSION CRITERIA: Studies with noncancer or pediatric samples, case studies, studies that did not report relevant outcomes, and studies not published in English

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 91
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: A qualitative data synthesis was used to describe outcomes. The studies did not measure outcomes in the same way, so the results could not be pooled. 

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 2 
  • TOTAL PATIENTS INCLUDED IN REVIEW = 22
  • KEY SAMPLE CHARACTERISTICS: Various types of cancer, primarily lung cancer; study 1 age range was 63–80 years, study 2 mean age was 66 years

Phase of Care and Clinical Applications

  • PHASE OF CARE: Multiple phases of care
  • APPLICATIONS: Palliative care

Results

In the two studies included in this review, neither study showed any benefit to nebulized furosemide for dyspnea when compared to controls. Both studies used different doses of nebulized furosemide. Neither study reported adverse effects.

Conclusions

Nebulized furosemide was not beneficial for the relief of dyspnea in patients with cancer.

Limitations

  • Only included two studies
  • Sample size was extremely small
  • Measured outcomes varied significantly between studies
  • Different doses of nebulized furosemide were used in each study
  • High attrition rates in included studies
  • Difficulty recruiting reported for included studies

Nursing Implications

Many patients with cancer experience feelings of dyspnea. Nurses should assess patients for the underlying causes of dyspnea and use appropriate interventions to treat these causes. In both intervention studies and in systematic reviews, nebulized furosemide has not been shown to be beneficial for patients with cancer who experience dyspnea.

Legacy ID

5251