Written by Ketan Patel
Spoon Feed
When time is of the essence, as in ovarian torsion, furosemide plus fluid provides a quick, effective, noninvasive option for bladder filling to expedite ultrasound in pediatric patients.
Flush and fill: beating the clock for ovarian torsion ultrasounds
Despite being prevalent at any age, ovarian torsion is most common post-menarche, with over half of diagnoses made in children 9-14 years old. In pediatrics, transabdominal ultrasound with color doppler is the preferred diagnostic modality and requires a well-distended bladder for accurate imaging. This randomized, placebo-controlled, single-blinded pilot study evaluated whether low-dose furosemide (0.1 mg/kg, max 5 mg) expedites bladder filling in females aged 8–18 undergoing ultrasound for suspected ovarian torsion. Among 34 participants, bladder filling occurred a median of 90 minutes sooner in the furosemide group (p ≤ 0.001). Radiology-performed ultrasound and final radiology interpretation occurred 92 and 94 minutes earlier, respectively (p ≤ 0.001). No adverse events were reported, suggesting furosemide effectively accelerates bladder filling for pelvic ultrasound. In comparison to filling the bladder with warm saline via a catheter or isolated IV fluids and waiting, this approach avoids otherwise invasive or lengthy delays to achieve optimize imaging.
How will this change my practice?
In the ED, where throughput metrics rule, expediting patient care by obtaining quicker imaging and diagnostics is a no-brainer. This is especially true in time-sensitive surgical emergencies, such as ovarian torsion. The studied approach seems like a win if ovarian torsion is suspected.
Source
Furosemide use to expedite bladder filling in pediatric females with suspected ovarian torsion: A randomized controlled pilot study. Am J Emerg Med. 2025 Jan 31;90:205-209. doi: 10.1016/j.ajem.2025.01.082. Epub ahead of print. PMID: 39922106
