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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)?
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.
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.
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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