ISSN:
1432-1238
Keywords:
Key words Topical furosemide
;
Lung mechanics
;
Plasma levels
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objective: Recent studies have suggested direct pulmonary effects of furosemide in asthmatics and infants with bronchopulmo- nary dysplasia. We tested the hypothesis that intratracheally administered furosemide also increases respiratory compliance in children after cardiac surgery, and investigated whether furosemide has a topical and/or systemic action. Study design: Prospective study with intra-individual control. In twelve infants and toddlers (age: 10 ± 8 months, weight: 6.9 ± 3 kg) mechanically ventilated for compromised lung mechanics after cardiac surgery, 0.5 mg/kg furosemide was intratracheally administered to the lungs. Lung mechanics were serially assessed using a computerised system (Sensormedics 2600) during a 2 h control and 2 h intervention period. Urine output was measured by an indwelling bladder catheter and levels of furosemide were determined in blood and tracheal aspirates. Results: Static compliance improved within 30 min in all patients, reached a maximum of 44 (20–85) % above baseline and remained improved throughout the study (p 〈 0.05). An immediate, short and significant diuretic effect of intratracheally applied furosemide was observed. Furosemide levels 1 h after intervention were 795 ng/ml in the blood and 431 μg/ml (i. e. 1000-fold higher) in the tracheal aspirate. Changes in compliance were correlated only to urine output values over the 2 h (r = 0.82, p = 0.044, n = 9) after furosemide administration. Conclusion: We conclude that intratracheally applied furosemide improves static compliance in infants and toddlers with compromised lung mechanics after cardiac surgery. We demonstrated that furosemide is absorbed from the lung and has a systemic effect within 15 min after its intratracheal instillation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001340050444
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