Evaluation of the Use of Combining of Hypertonic Saline Nebulizer and/or Furosemide Nebulizer to Attenuate the Manifestations of Acute Respiratory Distress Syndrome

Abstract

cute respiratory distress syndrome (ARDS) remains a significant source of morbidity and mortality in the critically ill patient population. Over the past two decades, a variety of interventions and intensive care strategies have been used in treating patients with ALI/ARDS. Current pharmaco-therapy for ARDS is not optimal, and there is a significant need for more effective medicinal chemical agents for use in these severe and lethal lung injury syndromes. A number of pharmacologic agents have been studied individually in ARDS, with limited or minimal success in improving survival. Hypertonic saline (HTS) may have Immunomodulatory effects as evidenced by reduction in the incidence of acute lung injury and infectious complications following hemorrhagic shock in patients whom are resuscitated by intravenous hypertonic saline. Clinically, inhaled hypertonic saline (HTS) is used to treat inflammation in cystic fibrosis (CF) and neonatal bronchiolitis. IL-8, a chemokine expressed by pulmonary epithelial cells and macrophages, is elevated in CF, and inhibited by hypertonic saline in vitro. Review of literature showed a potential benefit of nebulized furosemide for relieving dyspnea, which is most common complaint in ARDS patients. Results of our conducted study suggested that HTS nebulizer may cause more rapid improvement of lung injury score when compared to control group but not statistically