Systematic Review of Nebulized Furosemide for the Management of Dyspnea: Efficacy and Safety in Clinical Practice
Mahdi Behi *
Department of Pharmacology, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Babak Gholamine
Department of Pharmacology, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad Ali Darbandi
Department of R&D, Nafas Pharmed Pharmaceutical Company, Tehran, Iran.
Mohammad Reza Masjedi
Tobacco Control Research Center (TCRC), Iranian Anti-Tobacco Association, Tehran, Iran and Department of Pulmonary Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alireza Eslaminejad
Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis & Lung Diseases, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Esmaeil Idani
Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis & Lung Diseases, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Mohsen Sadeghi
Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis & Lung Diseases, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Akram Qanavati
Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis & Lung Diseases, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Sayed Mehran Marashian
Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis & Lung Diseases, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
*Author to whom correspondence should be addressed.
Abstract
Background: Nebulized furosemide, a non-opioid option for dyspnea, shows promise in alleviating breathlessness by reducing pulmonary edema and modulating airway receptors. While studies indicate improvements in symptoms and quality of life, optimal dosage and long-term safety require further investigation. Compared to earlier reviews, this study includes more recent evidence and takes a closer look at how nebulized furosemide works, how safe it is, and how it should be dosed for managing dyspnea.
Methods: This systematic review focused on randomized controlled trials and systematic reviews involving participants who experienced dyspnea and received nebulized furosemide as part of their treatment.
Results: Searches measured across three and additional sources using key terms databases with the time frame from 2014 to 2024 yielded 150 unduplicated papers. Finally, seven studies—two of which were systematic reviews—met inclusion criteria, assessing the short-term effects of nebulized furosemide on dyspnea and pulmonary function tests. Four studies reported a statistically significant improvement in patient-reported symptoms.
Conclusion: Although preliminary research suggests potential benefits of nebulized furosemide in symptom relief and pulmonary function improvement, the available data remains insufficient to confirm the therapy’s effectiveness definitively.
Keywords: Dyspnea, chronic obstructive pulmonary disease, asthma, furosemide