Moosavi Shakeeb H, Binks Andrew P, Lansing Robert W, Topulos George P, Banzett Robert B, Schwartzstein Richard M
Physiology Program, Harvard School of Public Health, and Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Respir Physiol Neurobiol. 2007 Apr 16;156(1):1-8. doi: 10.1016/j.resp.2006.07.004. Epub 2006 Aug 28.
Recent evidence suggests that inhaled furosemide relieves dyspnoea in patients and in normal subjects made dyspnoeic by external resistive loads combined with added dead-space. Furosemide sensitizes lung inflation receptors in rats, and lung inflation reduces air hunger in humans. We therefore hypothesised that inhaled furosemide acts on the air hunger component of dyspnoea. Ten subjects inhaled aerosolized furosemide (40 mg) or placebo in randomised, double blind, crossover experiments. Air hunger was induced by hypercapnia (50+/-2 mmHg) during constrained ventilation (8+/-0.9 L/min) before and after treatment, and rated by subjects using a 100 mm visual analogue scale. Subjects described a sensation of air hunger with little or no work/effort of breathing. Hypercapnia generated less air hunger in the first trial at 23+/-3 min after start of furosemide treatment (58+/-11% to 39+/-14% full scale); the effect varied substantially among subjects. The mean treatment effect, accounting for placebo, was 13% of full scale (P=0.052). We conclude that 40 mg of inhaled furosemide partially relieves air hunger within 1h and is accompanied by substantial diuresis.
近期证据表明，吸入速尿可缓解患者以及因外部阻力负荷加额外死腔而致呼吸困难的正常受试者的呼吸困难症状。速尿可使大鼠肺部膨胀感受器敏感化，而肺部膨胀可减轻人类的气促感。因此，我们推测吸入速尿作用于呼吸困难的气促成分。在随机、双盲、交叉试验中，10名受试者吸入雾化速尿（40毫克）或安慰剂。在治疗前后，于受限通气（8±0.9升/分钟）期间通过高碳酸血症（50±2毫米汞柱）诱发气促，并由受试者使用100毫米视觉模拟量表进行评分。受试者描述了一种几乎没有或完全没有呼吸做功/用力的气促感。在速尿治疗开始后23±3分钟的首次试验中，高碳酸血症诱发的气促减轻（从满量程的58±11%降至39±14%）；不同受试者之间的效果差异很大。考虑到安慰剂效应，平均治疗效果为满量程的13%（P = 0.052）。我们得出结论，40毫克吸入速尿在1小时内可部分缓解气促，并伴有大量利尿。
