Wilcock, A., Walton, A., Manderson, C., Feathers, L., El Khoury, B., Lewis, M., . . . Tattersfield, A. (2008). Randomised, placebo controlled trial of nebulised furosemide for breathlessness in patients with cancer. Thorax, 63(10), 872-875.doi: 10.1136/thx.2007.091538
The objective of the study is to assess the benefit of nebulized furosemide on breathlessness and respiratory function in patients with cancer.
Patients were assigned to receive 40 mg nebulized furosemide, nebulized 0.9% saline, and no treatment on three consecutive days in random order. Subjects were familiarized with the equipment and surrounding on day one of study and underwent assessments before and after administration of the assigned treatment. Spirometry was administered before and after nebulizer treatments. Following 10 minutes of rest, subjects underwent a reading test and arm exercise test and then rated their sensation of breathlessness intensity on a Borg scale. On nontreatment days, patients also underwent spirometry before and after the arm exercise test. Patients finally were asked if they had perceived benefits from the nebulized saline or furosemide treatments and whether they noted a difference between the two.
The study was conducted on a single-site, inpatient palliative care unit in England.
Patients were undergoing end-of-life and palliative care.
All 13 patients who completed the arm exercise test experienced increased breathlessness, but no significant difference between exercise duration and Borg score at maximum equivalent workload between the furosemide, saline, and no treatment group were observed. Average score at maximum equivalent workload indicated no significant difference among the three treatments. Six of 15 patients perceived improved ventilation following nebulized treatment, with 3 preferring saline, 1 preferring furosemide, and 2 finding either treatment equally beneficial.
Results do not support benefit of nebulized furosemide in patients with cancer-related breathlessness.
Results do not support the use of nebulized furosemide in the management of dyspnea.