Furosemide use to expedite bladder filling in pediatric females with suspected ovarian torsion: A randomized controlled pilot study.

OBJECTIVE

The act of filling the bladder prior to obtaining an ultrasound is often the rate limiting factor in the diagnosis of ovarian torsion in pediatric females. The objective of this study was to evaluate if low dose furosemide plus IV fluid administration results in faster bladder filling time in comparison to IV fluid administration alone in females age 8-18 with suspected ovarian torsion.

METHODS

This was a randomized, placebo controlled, single blinded pilot study using convenience sampling to target females ages 8 to 18 years seen in the pediatric emergency department and undergoing a trans-abdominal pelvic US to assess for ovarian torsion. Enrolled patients were assigned to the experimental group, receiving 0.1 mg/kg (max 5 mg) of furosemide, or the control group, receiving a 5 mL normal saline (NS) flush. Point of Care Ultrasound (POCUS) evaluation of the bladder was performed every 30 min until the bladder was determined to be of adequate size and morphology to perform the trans-abdominal pelvic US.

RESULTS

Bladder filling as confirmed by POCUS occurred a median of 90 min sooner in the furosemide group compared with the control group (p ≤0.001). Compared with the control group, radiology-performed US occurred 92 min sooner (p ≤0.001) and US interpretation by a radiologist occurred 94 min sooner (p ≤0.001) for individuals receiving furosemide.

CONCLUSION

Furosemide administration leads to a statistically and clinically significant difference in the time to fill the bladder of pediatric females awaiting pelvic US and leads to more rapid ultrasonography and interpretation by a radiologist in our setting.