Double-masked,randomized,placebo-controlled trial of furosemide after packed red blood cell transfusion in preterm infants

Abstract

Objective: To assess the effectiveness of furosemide therapy to prevent hemodynamic and respiratory compromise in electively transfused preterm infants.

Methods: Twenty preterm infants (birth weight: 878.5 ± 207 g; gestational age: 26 ± 1.3 weeks) with RDS requiring conventional mechanical ventilation were randomly assigned to receive either a single intravenous dose of furosemide (1 mg/kg) or an equivalent volume of placebo (normal saline) at the completion of an elective "top off" 3-hour transfusion (15 mL/kg) of packed red blood cells (PRBC) during the first 2 weeks of life. Multiple clinical and respiratory parameters were recorded during the transfusion.

Results: Twelve of the 20 infants (60%) received furosemide while 8 infants received placebo at a median postnatal age of 6 days. The clinical parameters (SPO $_{2}$ , BP, HR, spontaneous RR), ventilatory parameters (minute ventilation, compliance, and resistance), PaCO $_{2}$ , or A-a DO $_{2}$ were similar in the furosemide and placebo treated groups at the completion of the transfusion, and at 4 hours after completion of the transfusion.

Conclusion: In this pilot study, a single dose of furosemide after PRBC transfusion did not alter the clinical or pulmonary parameters compared to placebo during the 4 hour period following the transfusion. Its continued use for this purpose may not be justified.