Lasix In Acute Asthma Exacerbation

Posted

Hi All!

So recently in my ED I've seen our docs order lasix 20mg IVP for patients with acute asthma exacerbations who do not have history of cardiac issues.

It doesn't seem to be a trend among all of our ED docs because I've only seen it twice. Both patient were under 40 years of age and had no cardiac history. It did not seem to help their breathing and only gave them the runs.

I've tried to look up a correlation but I can only find scholarly articles regarding inhaled lasix in acute asthma of which most are dated and inconclusive.

Our will ask one of our attendings the next time I am on but just wondering has anyone seen this in practice?

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience. 1 Article; 4,094 Posts

I've had many severe asthma attacks and have had all kinds of treatments, but never that. I'm guessing that they're ruling out a pulmonary edema component.

sallyrnrrt, ADN, RN

Specializes in critical care, ER,ICU, CVSURG, CCU. 2,395 Posts

i agree with blondy ;)

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience. 142 Articles; 9,940 Posts

In the absence of CHF or pulmonary edema, I can't imagine why an MD would order Lasix.

TU RN

Specializes in ICU, PCU. Has 9 years experience. 458 Posts

I've tried to look up a correlation but I can only find scholarly articles regarding inhaled lasix in acute asthma of which most are dated and inconclusive.

Perhaps your docs are conducting such a study.

GrannyRRT

188 Posts

What did their CXR look like? Did the patients also have a history of hypertension? Long term asthma with remodeling and possibly a chance for pulmonary hypertension? Long term anticholinergic therapy and urinary retention?

The theory behind Lasix as a bronchodilator holds some value but it has not been demonstrated as effective in a handful of trials for IV Lasix in the mid 2000s. Nebulized Lasix has appeared, disappeared and reappeared as a treatment option for bronchodilating over the past 20+ years but there is not enough evidence to include it in the mainstream treatment plan. Today I see it primarily in end stage diseases where introducing something new or different might have some affect even if more psychological.

sallyrnrrt, ADN, RN

Specializes in critical care, ER,ICU, CVSURG, CCU. 2,395 Posts

GrannyRRT said it best :)