Abstract
Background
Chronic Obstructive Pulmonary Disease (COPD) represents a major global health burden. While most COPD trials focus on acute exacerbations, there is limited evidence in stable COPD. Prior research on nebulized furosemide was also predominantly in exacerbated COPD patients.
Objective
We aimed to evaluate the impact of adding nebulized furosemide as adjuvant therapy to conventional treatments in patients with very severe stable COPD.
Methods
We conducted a triple-blinded, crossover, randomized controlled trial at Alexandria University Hospital Chest Clinic. Patients with stable COPD were randomized to receive either nebulized furosemide or saline plus salbutamol-ipratropium, with crossover after a washout period. Spirometry was performed at baseline and after each treatment.
Results
92 patients completed the trial. Compared to saline, furosemide significantly improved FVC, FEV1, and FEV1/FVC ratio. Furosemide increased FVC by 9.42% versus 5.83% with saline (p < 0.001), with similar FEV1 improvements. The FEV1/FVC ratio increased by 3.32% with furosemide (p < 0.05) but not saline. Heart failure and smoking pack-years negatively impacted lung function.
Conclusions
In stable COPD, nebulized furosemide significantly enhances bronchodilation from salbutamol-ipratropium compared to saline. Furosemide could provide a good adjunctive therapy for stable COPD management.