Affiliations: Department of Pediatrics, Division of
Neonatal-Perinatal Medicine, University of Michigan Health System, C. S. Mott
Children's Hospital, Ann Arbor, MI 48109, USA | Department of Pediatrics, Critical Care Support
Services, University of Michigan Health System, C. S. Mott Children's Hospital,
Ann Arbor, MI 48109, USA
Note: [] Corresponding author: Subrata Sarkar, MD, Neonatal-Perinatal
Medicine, University of Michigan Health System, F5790 C.S. Mott Children's
Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0254, USA. Tel.: +1
734 763 4109; Fax: +1 734 763 7728; E-mail: [email protected]
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.
