Intravenous frusemide for transient tachypnoea of the newborn: a randomised controlled trial. Effect of furosemide on the clinical course of transient tachypnea of the newborn.
To investigate the effect of intravenous frusemide on the course of transient tachypnoea of the newborn (TTN).
                Fifty term infant with TTN were randomised at the time of diagnosis to receive either intravenous frusemide 2 mg/kg or saline placebo. Outcomes assessed included duration of supplemental oxygen requirement, the period of tachypnoea, time to discharge from hospital and weight loss in the first 24 h of life and before discharge.
                The two groups were similar with respect to sex, birthweight, mode of delivery and age at presentation. The study group lost significantly more weight in the first 24 h after birth. There were no significant differences between the two groups in the duration of oxygen requirements, the period of tachypnoea and the time to hospital discharge.
                A single dose of intravenous frusemide (2 mg/kg) does not improve the clinical course of TTN. This finding suggests that either frusemide is not effective in promoting resorption of lung fluid or factors other than delayed resorption of this fluid contribute to the pathogenesis of TTN. The effect of furosemide on the course of transient tachypnea of the newborn was evaluated in a controlled, prospective study. Fifty infants with transient tachypnea of the newborn were randomly assigned to control or treatment groups. Those in the treatment group were given furosemide, 2 mg/kg orally, at the time of diagnosis followed by 1 mg/kg 12 hours later if the symptoms persisted. Infants in the control group received a placebo. Compared with infants in the control group, the furosemide-treated group demonstrated no significant difference in the duration of tachypnea nor in the length of hospitalization. It is concluded that oral furosemide, at the doses used in this study, does not significantly affect the clinical course of transient tachypnea of the newborn.
Oral or intravenous furosemide cannot be recommended as treatment for transient tachypnoea of the newborn and it should not be used unless additional data become available. This finding suggests that either furosemide is not effective in promoting resorption of lung fluid, or factors other than delayed resorption of this fluid contribute to the pathogenesis of transient tachypnoea of the newborn. The question remains as to whether furosemide given to the infant (or even to the mother before caesarean section) might shorten the duration of the illness. As elective caesarean section continues at a high level, these two interventions might be worthy of trials.