Published ahead of print on February 20, 2004, doi:10.1164/rccm.200308-1171OC Am. J. Respir. Crit. Care Med., Volume 169, Number 9, May 2004, 1028-1033 A more recent version of this article appeared on May 1, 2004
Submitted on August 27, 2003 Effects of Inhaled Furosemide on Exertional Dyspnea in Chronic Obstructive Pulmonary DiseaseKian-Chung Ong1*,1 Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore, Singapore, 2 Clinical Research Unit, Tan Tock Seng Hospital, Singapore, Singapore * To whom correspondence should be addressed. E-mail: kian_chung_ong{at}ttsh.com.sg.
The aim of this study is to investigate the effects of inhaled furosemide on the sensation of dyspnea produced during exercise in patients with stable chronic obstructive pulmonary disease (COPD). In a double blind, randomized, crossover study we compared the effect of inhaled furosemide on dyspneic sensation during exercise testing with that of placebo. Spirometry, incremental and constant-load exercise testing were performed after inhalation of placebo or furosemide on 2 separate days in 19 patients with moderate or severe COPD. Subjects were asked to rate their sensation of respiratory discomfort using a 100mm visual analogue scale (VAS). There was significant improvement in mean FEV1 and FVC after inhalation of furosemide (p = 0.038 and 0.005 respectively) but not after placebo. At standardised exercise time during constant-load exercise testing but not during incremental exercise, the mean dyspneic VAS score was lower after inhalation of furosemide compared to placebo (33.7 ± 25.2 versus 42.4 ± 24.0 respectively, p = 0.014). We conclude that inhalation of furosemide alleviates the sensation of dyspnea induced by constant-load exercise testing in patients with COPD and that there is significant bronchodilation after inhalation of furosemide compared to placebo in these patients. Key words: exercise capacity, bronchodilation, breathlessness, exercise test, spirometry
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