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QUESTION 2: Is frusemide necessary following red cell transfusion in preterm neonates?
  1. Peter Cosgrove,
  2. Eleanor J Molloy
  1. 1 Department of Paediatrics, Trinity College Dublin, The University of Dublin, National Children's Hospital, Tallaght, Dublin, Ireland
  2. 2 National Children's Research Centre, Crumlin, Dublin, Ireland
  3. 3 Department of Neonatology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
  4. 4 Department of Paediatrics, Coombe Women and Infants University Hospital, Dublin, Ireland
  1. Correspondence to Professor Eleanor Molloy, Department of Paediatrics, Trinity Centre for Health Sciences, Tallaght, Dublin 24, Ireland; Eleanor.molloy{at}tcd.ie

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Scenario

A 26-week gestation baby girl with a birth weight of 650 g is now 32 weeks corrected age and clinically stable on low flow nasal prong oxygen. A red blood cell (RBC) transfusion is planned for symptomatic anaemia and haemoglobin of 7.5 g/dL. The consultant requests a blood transfusion of packed red cells of 20 mL/kg to be followed by frusemide of 1 mg/kg. The medical student asks why frusemide is required after blood transfusion when this is not standard practice in adult medicine.

Structured clinical question

In a preterm infant with anaemia requiring packed red cell transfusion (patient), does frusemide (therapy) improve respiratory and long-term outcome (outcome)?

Search strategy

Primary sources

An advanced search of MEDLINE using the terms ‘(frusemide OR furosemide) AND (neonate OR neonatal) AND (transfusion)’ up until July 2016 was used with 20 hits found of which 14 were irrelevant.

Secondary sources

A search of the Cochrane Library using the search terms ‘(frusemide OR frusemide) AND (neonate OR neonatal) and (transfusion)’ were used with one result found.

Commentary

Preterm neonates have high transfusion rates and receive approximately 300 000 RBC transfusions annually in the USA.1 RBC transfusions are the most commonly used blood product with 17% of all neonates received in at least one transfusion.2 Infants who frequently require …

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