Furosemide: Would it help to improve the lungs as evaluated by sonography and compliance during aortic coarctation surgery

Mohammed, Ahmed; Madkour, Mai A.; Hassanien, Hossam M

doi:10.4103/aca.aca_55_18

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Comparing preoperative and postoperative LUS scores and PaO 2 /FiO 2 , we found a significant negative correlation between B-lines and oxygenation. This is in agreement with a study of two groups of patients undergoing coarctation repair and treated with furosemide in which lung oedema and B-lines, scored by LUS, were less in the treated group [ 6 ]. Picano and Pellikka discussed that LUS could detect subclinical forms of pulmonary edema represented as B-lines [ 7 ].…”

Section: Discussionsupporting

confidence: 92%

Extravascular Lung Water and Effect on Oxygenation Assessed by Lung Ultrasound in Adult Cardiac Surgery

Emperador¹,

Bennett²,

Gonzalez³

et al. 2020

Cureus

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Introduction The extravascular lung water content is determined by the use of lung ultrasound (LUS) which is represented as B-lines. The aim of this study was to investigate whether the LUS measurement of extravascular lung water was correlated to changes in oxygenation. Methods This prospective cohort study was comprised of 73 patients with an average age of 56 (range: 18 to 87 years) who underwent elective cardiac surgery using cardiopulmonary bypass. The LUS score was performed preoperatively, time zero (T0), at one hour (T1), and at 24 hours (T2) post-surgery. Additionally, arterial oxygen partial pressure and fraction of inspired oxygen (PaO 2 /FiO 2 ) ratio were measured at each time and the time-to-extubation. Results A negative correlation was found between the LUS score and PaO 2 /FiO 2 at T1 (p < 0.004). Extubation time and changes in the lung ultrasound score at T0 - T2 were positively correlated (p < 0.03). Plus, there was a positive correlation between fluid balance and lung ultrasound score at T2 (p < 0.03). Conclusion We found three significant correlations that support the use of LUS in cardiac surgery: 1) the more B-lines, the lower the oxygenation; 2) the more B-lines, the longer the period of ventilation; 3) the more B-lines, the more positive the fluid balance. LUS is a non-invasive bedside investigation that can be used to judge extravascular lung water, providing useful information in the management of patient oxygenation, fluid balance, and extubation.

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Section: Discussionsupporting

confidence: 92%

Extravascular Lung Water and Effect on Oxygenation Assessed by Lung Ultrasound in Adult Cardiac Surgery

Emperador¹,

Bennett²,

Gonzalez³

et al. 2020

Cureus

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Ультразвуковое Исследование Легких В Отделении Анестезиологии-Реанимации Детского Кардиохирургического Профиля: Обзор Литературы

Грицан,

Пфейфер,

Гурченко

et al. 2024

Annals of Critical Care

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INTRODUCTION: Pediatric cardiac surgery is associated with a high risk of developing acute respiratory failure in the early postoperative period. An anesthesia and intensive care specialist has to make effective and quick decisions of the intensive care tactics considering the severity of the children’s condition, limited capacity of transporting and radiation exposure. As a result, there is the demand for a simple, quick, safe and highly sensitive method available to the anesthesia and intensive care specialist at the bedside, which may be met through implementation of routine lung ultrasound. OBJECTIVE: To combine, organize and analyze the data on application of lung ultrasound as a bedside diagnostic method in pediatric cardiac surgery. MATERIALS AND METHODS: Two independent researchers conducted a systematic review of articles published within the period from 2013 to 2023 in English (PubMed, Google Scholar) and Russian (eLibrary, Google Scholar) databases according to the PRISMA protocols. The search was based on the queries: “lung ultrasound”, “children”, “cardiac surgery”, “respiratory failure” in both English and Russian. The overall search result was 528 articles in English with 494 excluded from search after title and abstract reading. A total of 34 articles were considered for inclusion with 20 falling under at least one exclusion criterion. The final selection for detailed analysis was 14 articles. In Russian, a total of 897 articles were found, all of which were considered inappropriate for a systematic review. RESULTS: A total of 14 articles were studied to reveal information on the role of lung ultrasound in pediatric cardiac surgery as a method for diagnosis and assessment of interstitial syndrome, atelectasis, pneumothorax, diaphragmatic function and complex combined lung diseases. The utility of perioperative lung ultrasound and the effect of recruitment maneuver under ultrasound guidance as well as ultrasound predictors of successful tracheal extubation were assessed in children after cardiac surgery. CONCLUSIONS: The literature analysis has revealed that this bedside diagnostic method makes it possible to diagnose pulmonary edema, atelectasis, pneumothorax, to assess the diaphragmatic function, to perform visually guided recruitment maneuver as well as to predict successful tracheal extubation in pediatric cardiac surgery.

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Analysis of Survival Modification by Furosemide Use in a Cohort of Hospitalized COVID-19 Patients with Severe or Critical Disease in Mexico: Due to Its Chemical Structure, Furosemide Is More than Just a Diuretic

Diaz-Martinez,

Kotzker,

Mendoza-Hernandez

et al. 2024

Pharmaceutics

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In the ongoing fight against Coronavirus Disease 2019 (COVID-19), researchers are exploring potential treatments to improve outcomes, especially in severe cases. This includes investigating the repurposing of existing medications, such as furosemide, which is widely available. This study aimed to evaluate the impact of furosemide on mortality rates among COVID-19 patients with severe or critical illness. We assessed a cohort of 515 hospitalized adults who experienced a high mortality rate of 43.9%. Using a multivariate analysis with adjusted risk ratios (AdRRs), factors like smoking (AdRR 2.48, 95% CI 1.53–4.01, p < 0.001), a high Pneumonia Severity Index (PSI) score (AdRR 7.89, 95% CI 5.82–10.70, p < 0.001), mechanical ventilation (AdRR 23.12, 95% CI 17.28–30.92, p < 0.001), neutrophilia (AdRR 2.12, 95% CI 1.52–2.95, p < 0.001), and an elevated neutrophil-to-lymphocyte ratio (NLR) (AdRR 2.39, 95% CI 1.72–3.32, p < 0.001) were found to increase mortality risk. In contrast, vaccination and furosemide use were associated with reduced mortality risk (AdRR 0.58, p = 0.001 and 0.60, p = 0.008; respectively). Furosemide showed a pronounced survival benefit in patients with less severe disease (PSI < 120) and those not on hemodialysis, with mortality rates significantly lower in furosemide users (3.7% vs. 25.7%). A Kaplan–Meier analysis confirmed longer survival and better oxygenation levels in patients treated with furosemide. Furthermore, a Structure–Activity Relationship analysis revealed that furosemide’s sulfonamide groups may interact with cytokine sites such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), potentially explaining its beneficial effects in COVID-19 management. These findings suggest that furosemide could be a beneficial treatment option in certain COVID-19 patient groups, enhancing survival and improving oxygenation.

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Furosemide: Would it help to improve the lungs as evaluated by sonography and compliance during aortic coarctation surgery

Cited by 3 publications

References 17 publications

Extravascular Lung Water and Effect on Oxygenation Assessed by Lung Ultrasound in Adult Cardiac Surgery

Extravascular Lung Water and Effect on Oxygenation Assessed by Lung Ultrasound in Adult Cardiac Surgery

Ультразвуковое Исследование Легких В Отделении Анестезиологии-Реанимации Детского Кардиохирургического Профиля: Обзор Литературы

Analysis of Survival Modification by Furosemide Use in a Cohort of Hospitalized COVID-19 Patients with Severe or Critical Disease in Mexico: Due to Its Chemical Structure, Furosemide Is More than Just a Diuretic

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