Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in Tehran

Abstract Background Acute dyspnea is a common presentation in emergency departments (EDs), which is one of the main complaints of the patients. There is an urgent need for an effective treatment plan for dyspnea. This study aims to compare the efficacy of inhalant furosemide, oxygen therapy, and pla...

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Main Authors: Mahdi Rezai, Danyal Yarahmadi, Mojde Mirkheshti, Mehrad Aghili, Reza Mosadegh, Kourosh Javdani Esfehani, Saeed Abbasi, Fatemeh Naseri Rad
Format: Article
Language:English
Published: BMC 2025-07-01
Series:International Journal of Emergency Medicine
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Online Access:https://doi.org/10.1186/s12245-025-00931-2
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author Mahdi Rezai
Danyal Yarahmadi
Mojde Mirkheshti
Mehrad Aghili
Reza Mosadegh
Kourosh Javdani Esfehani
Saeed Abbasi
Fatemeh Naseri Rad
author_facet Mahdi Rezai
Danyal Yarahmadi
Mojde Mirkheshti
Mehrad Aghili
Reza Mosadegh
Kourosh Javdani Esfehani
Saeed Abbasi
Fatemeh Naseri Rad
author_sort Mahdi Rezai
collection DOAJ
description Abstract Background Acute dyspnea is a common presentation in emergency departments (EDs), which is one of the main complaints of the patients. There is an urgent need for an effective treatment plan for dyspnea. This study aims to compare the efficacy of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to EDs in Tehran by Emergency Medical Services (EMS). Methods This randomized clinical trial included patients aged 18 to 75 who experienced acute dyspnea and were delivered to the ED by EMS during 2021 and 2022. Participants were randomly assigned to one of three groups: inhalant furosemide, oxygen therapy, or placebo (distilled water) which every group received the medication before entering EDs in a prehospital setting. Results The mean age of patients was 52.63 ± 20.48 years including 124 women (47.7%) and 136 men (52.3%). Our finding indicates that dyspnea intensity, heart rate, blood pressure, and oxygen saturation showed no significant differences among the groups (p-value). However, these parameters significantly improved in both the treatment and placebo groups (p-value). The mean degree of dyspnea in the furosemide group was lower than that in the other two groups, although the difference was not statistically significant. Hospitalization duration was significantly shorter in the furosemide group compared to the oxygen therapy and placebo groups. Conversely, ICU admission duration was significantly shorter in the oxygen therapy group than in the other two groups. Patient satisfaction levels did not differ significantly across groups. Conclusion The main effect of inhalant Furosemide in this study was reducing the patient’s length of hospitalization. It seems that Furosemide can have positive effects and can be used as a cure according to its low side effects, also this drug isn’t expensive and its mechanism of action, side effects, and pharmacokinetics have been shown and understood. Trial registration This study was registered with the IUMS Ethics Committee, receiving the ethical code (IR.IUMS.REC.1399.632), it was also listed in the Iranian Registry of Clinical Trails (IRCT20151003024317N12) on November the 10th, 2020.
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publishDate 2025-07-01
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series International Journal of Emergency Medicine
spelling doaj-art-7b96dff550e94d9083d3b4e0b5d43b5e2025-08-20T03:42:23ZengBMCInternational Journal of Emergency Medicine1865-13802025-07-011811710.1186/s12245-025-00931-2Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in TehranMahdi Rezai0Danyal Yarahmadi1Mojde Mirkheshti2Mehrad Aghili3Reza Mosadegh4Kourosh Javdani Esfehani5Saeed Abbasi6Fatemeh Naseri Rad7Emergency Medicine Management Research Center, Health Management Research Institute, Iran University of Medical SciencesSchool of Medicine, Iran University of Medical SciencesFaculty of Medicine, Iran University of Medical SciencesDepartment of Emergency Medicine, Tehran University of Medical SciencesDepartment of Emergency Medicine, Faculty of Medicine, Iran University of Medical SciencesIranian HospitalDepartment of Emergency Medicine, Faculty of Medicine, Iran University of Medical SciencesSchool of Medicine, Iran University of Medical SciencesAbstract Background Acute dyspnea is a common presentation in emergency departments (EDs), which is one of the main complaints of the patients. There is an urgent need for an effective treatment plan for dyspnea. This study aims to compare the efficacy of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to EDs in Tehran by Emergency Medical Services (EMS). Methods This randomized clinical trial included patients aged 18 to 75 who experienced acute dyspnea and were delivered to the ED by EMS during 2021 and 2022. Participants were randomly assigned to one of three groups: inhalant furosemide, oxygen therapy, or placebo (distilled water) which every group received the medication before entering EDs in a prehospital setting. Results The mean age of patients was 52.63 ± 20.48 years including 124 women (47.7%) and 136 men (52.3%). Our finding indicates that dyspnea intensity, heart rate, blood pressure, and oxygen saturation showed no significant differences among the groups (p-value). However, these parameters significantly improved in both the treatment and placebo groups (p-value). The mean degree of dyspnea in the furosemide group was lower than that in the other two groups, although the difference was not statistically significant. Hospitalization duration was significantly shorter in the furosemide group compared to the oxygen therapy and placebo groups. Conversely, ICU admission duration was significantly shorter in the oxygen therapy group than in the other two groups. Patient satisfaction levels did not differ significantly across groups. Conclusion The main effect of inhalant Furosemide in this study was reducing the patient’s length of hospitalization. It seems that Furosemide can have positive effects and can be used as a cure according to its low side effects, also this drug isn’t expensive and its mechanism of action, side effects, and pharmacokinetics have been shown and understood. Trial registration This study was registered with the IUMS Ethics Committee, receiving the ethical code (IR.IUMS.REC.1399.632), it was also listed in the Iranian Registry of Clinical Trails (IRCT20151003024317N12) on November the 10th, 2020.https://doi.org/10.1186/s12245-025-00931-2Inhalant furosemidePlaceboNebulizerDyspnea
spellingShingle Mahdi Rezai
Danyal Yarahmadi
Mojde Mirkheshti
Mehrad Aghili
Reza Mosadegh
Kourosh Javdani Esfehani
Saeed Abbasi
Fatemeh Naseri Rad
Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in Tehran
International Journal of Emergency Medicine
Inhalant furosemide
Placebo
Nebulizer
Dyspnea
title Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in Tehran
title_full Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in Tehran
title_fullStr Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in Tehran
title_full_unstemmed Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in Tehran
title_short Comparison of the effects of inhalant furosemide, oxygen therapy, and placebo in patients with acute dyspnea referred to emergency departments by EMS in various hospitals in Tehran
title_sort comparison of the effects of inhalant furosemide oxygen therapy and placebo in patients with acute dyspnea referred to emergency departments by ems in various hospitals in tehran
topic Inhalant furosemide
Placebo
Nebulizer
Dyspnea
url https://doi.org/10.1186/s12245-025-00931-2
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