• Kristy Williamson, Gabriel Bredin, Jahn Avarello, and Sandeep Gangadharan.
• Department of Pediatric Emergency Medicine, Cohen Children's Medical Center of New York, New Hyde Park, New York.
• J Emerg Med. 2018 Jan 1; 54 (1): 40-46.

BackgroundBronchiolitis is one of the most common disorders of the lower respiratory tract in infants. While historically diuretics have been used in severe bronchiolitis, no studies have looked directly at their early use in children in the emergency department.ObjectiveThe primary objective of this study was to determine whether a single early dose of a diuretic in infants with moderate to severe bronchiolitis would improve respiratory distress. Secondary objectives examined whether it reduced the use of noninvasive ventilation and hospital length of stay.MethodsPatients diagnosed with clinical bronchiolitis were enrolled at a tertiary care, academic children's hospital over a 3-year period. This was a double-blind, randomized controlled trial in which subjects were randomly assigned to either furosemide or placebo. Respiratory rate and oxygen saturation at the time of medication delivery and at 2 and 4 h post-intervention were recorded, as well as other data. Exact logistic regression was used to examine associations.ResultsThere were 46 subjects enrolled and randomized. There was no difference in respiratory rates, measured as a decrease of ≥ 25%, at both 2 and 4 h after intervention between furosemide and placebo groups (odds ratios 1.13 and 1.13, respectively). There was also no difference in oxygen saturation, intensive care unit admission rate, or hospital length of stay between groups.ConclusionsWhile theoretically a single dose of a diuretic to reduce lung fluid would improve respiratory distress in children with bronchiolitis, our randomized controlled medication trial showed no difference in outcomes. ClinicalTrials.gov ID: NCT02469597.Copyright © 2017 Elsevier Inc. All rights reserved.

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