Effects of intravenous furosemide on mucociliary transport and rheological properties of patients under mechanical ventilation.docVIP

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Effects of intravenous furosemide on mucociliary transport and rheological properties of patients under mechanical ventilation.doc

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Available online /content/6/1/081 Research article Effects of intravenous furosemide on mucociliary transport and rheological properties of patients under mechanical ventilation Cláudia Seiko Kondo*?, Mariangela Macchionne*, Naomi Kondo Nakagawa*?, Carlos Roberto Ribeiro de Carvalho*, Malcolm King?, Paulo Hilário Nascimento Saldiva*, Geraldo Lorenzi-Filho* *Universidade de S?o Paulo, S?o Paulo, Brazil ?Universidade Federal de S?o Paulo and Escola Paulista de Medicina, S?o Paulo, Brazil ?Pulmonary Research Group, Edmonton, Alberta, Canada Correspondence: Geraldo Lorenzi-Filho, geraldo.lorenzi@incor.usp.br Received: 14 February 2001 Critical Care 2002, 6:81-87 Revisions requested: 31 August 2001 Revisions received: 19 September 2001 Accepted: 23 October 2001 This article is online at /content/6/1/081 ? 2002 Kondo et al., licensee BioMed Central Ltd Published: 19 November 2001 (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract The use of intravenous (IV) furosemide is common practice in patients under mechanical ventilation (MV), but its effects on respiratory mucus are largely unknown. Furosemide can affect respiratory mucus either directly through inhibition of the NaK(Cl) co-transporter on the basolateral surface of 2 airway epithelium or indirectly through increased diuresis and dehydration. We investigated the physical properties and transportability of respiratory mucus obtained from 26 patients under MV distributed in two groups, furosemide (n = 12) and control (n = 14). Mucus collection was done at 0, 1, 2, 3 and 4 hours. The rheological properties of mucus were studied with a microrheometer, and in vitro mucociliary transport (MCT) (frog palate), contact angle (CA) and cough clearance (CC) (simulated cough machine) were measured. After the administration of furosemide, MCT decreased by 17 ± 19%, 24 ± 11%, 18 ± 16% and 18 ± 13% at 1, 2, 3 and 4 hours respectively, P 0.001 compared wi