Wilcock A, Walton A, Manderson C, Feathers L, El Khoury B, Lewis M, Chauhan A, Howard P, Bell S, Frisby J, Tattersfield A
Department of Palliative Medicine, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, UK.
Thorax. 2008 Oct;63(10):872-5. doi: 10.1136/thx.2007.091538. Epub 2008 Apr 11.
Breathlessness is a common and difficult symptom to treat in patients with cancer. Case reports suggest that nebulised furosemide can relieve breathlessness in such patients but few data are available.
Patients with primary or secondary lung cancer and a Dyspnoea Exertion Scale score of >or=3 were recruited. Following familiarisation, patients received either nebulised furosemide 40 mg or nebulised 0.9% saline under double blind conditions or no treatment, in random order on 3 consecutive days. Patients undertook number reading and arm exercise tests to assess breathlessness and its impact, and were asked to report subjective benefit and any preference between nebulised treatments.
15 patients took part. There were no differences between furosemide, saline and no treatment in the outcomes of the number reading test (eg, mean number read per breath was 6.7, 6.4 and 6.7, respectively) or arm exercise test (eg, mean Borg score at maximum equivalent workload was 2.3, 2.5 and 2.7, respectively). No adverse effects were reported, although there was a small fall in forced expiratory volume in 1 s and forced vital capacity following saline. Six patients considered that their breathlessness improved with nebulised treatment, three preferring saline, one furosemide and two reporting they were of equal benefit.
Our findings do not support a beneficial effect from nebulised furosemide in patients with cancer related breathlessness. Listed on the National Research Register (N0170118249) and the UK Clinical Research Network Portfolio Database (1428).
呼吸困难是癌症患者常见且难以治疗的症状。病例报告表明雾化呋塞米可缓解此类患者的呼吸困难，但相关数据较少。
招募原发性或继发性肺癌且呼吸困难运动量表评分≥3分的患者。在熟悉流程后，患者在双盲条件下连续3天随机接受雾化40mg呋塞米、雾化0.9%生理盐水或不接受治疗。患者进行数字阅读和手臂运动测试以评估呼吸困难及其影响，并被要求报告主观获益以及对雾化治疗的偏好。
15名患者参与。在数字阅读测试结果（例如，每次呼吸平均阅读数字分别为6.7、6.4和6.7）或手臂运动测试结果（例如，最大等效工作量时的平均Borg评分为2.3、2.5和2.7）方面，呋塞米、生理盐水组和未治疗组之间无差异。尽管生理盐水治疗后1秒用力呼气量和用力肺活量略有下降，但未报告不良反应。6名患者认为雾化治疗后呼吸困难有所改善，3人更喜欢生理盐水，1人更喜欢呋塞米，2人报告两者获益相同。
我们的研究结果不支持雾化呋塞米对癌症相关呼吸困难患者有有益作用。列入国家研究注册库（N0170118249）和英国临床研究网络组合数据库（1428）。
