Furosemide infusion in children with dengue fever and hypoxemia

OBJECTIVES: To study the role of furosemide infusion in the management of Acute respiratory distress syndrome (ARDS) associated with dengue fever. METHODS: Children between the ages of 1 month to 18 years, who fulfilled the WHO clinical criteria for dengue infection and American European Consensus Criteria criteria for ARDS with Dengue IgM positivity, were evaluated. Patients were studied as group D (receiving diuretic therapy alone) and group B (both ventilation and diuretics), and compared to a historical control group V (ventilation alone). Furosemide infusion was administered at 0.05–0.1 mg/kg/hour for 48 hours, maintaining a urine output of 2–4 mL/kg/hour. RESULTS: There was a significant difference in survival in the three groups. Significant difference was noted between pre- and postintervention arterial blood gases with respect to PCO(2) (P=0.02), pO(2) (P=0.003), PaO(2)/FaO(2) ratio (P<0.001) and alveolar-arteriolar oxygen gradient (P=0.002). CONCLUSION: Diuretic infusion improves outcome in dengue with ARDS.