Using Furosemide to Prevent Fluid Overload During Red Blood Cell Transfusion in Neonates

February 19, 2008 updated by: The Hospital for Sick Children

A Randomized Controlled Trial of Furosemide to Prevent Fluid Overload During Red Blood Cell Transfusion in Neonates

The purpose of this study is to investigate the effects of intravenous furosemide on cardio-respiratory performance in neonates receiving a packed red blood cell (PRBC) transfusion who are considered at high risk of volume overload.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

Red cell transfusion is a very common practice in neonates, particularly in preterm infants. It has been estimated that approximately 300,000 neonates undergo transfusions annually. The decision to administer a blood transfusion to a sick anemic neonate is made after consideration of multiple clinical factors, including: poor weight gain, oxygenation failure, and recurrent apnea and bradycardia. These decisions are also influenced by physician preferences. For many years, furosemide has been used routinely by physicians during and after blood transfusions in neonates and other age groups. The rationale behind this common practice is to reduce the vascular overload that may be imposed by the additional blood volume delivered during transfusion. This belief, however, lacks the support of scientific clinical evaluation.

Study Type

Interventional

Enrollment (Anticipated)

64

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Ontario
      • Toronto, Ontario, Canada, M5G 1X8
        • Not yet recruiting
        • The Hospital for Sick Children
        • Contact:
        • Principal Investigator:
          • Patrick McNamara, MD
        • Sub-Investigator:
          • Walid El-Naggar, MD
        • Sub-Investigator:
          • Anna Taddio, PhD
      • Toronto, Ontario, Canada, M5G 1X5
        • Recruiting
        • Mount Sinai Hospital
        • Contact:
        • Principal Investigator:
          • Edmond Kelley, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

1 week to 10 months (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Less than 44 weeks corrected gestational age
  • Receiving a red cell transfusion
  • Satisfy one of the following criteria:

    • Echocardiographic evidence of a hemodynamically significant ductus arteriosus (HSDA) defined by a transductal diameter >1.5 mm and unrestrictive systemic-pulmonary trans-ductal flow
    • Clinical evidence of significant lung disease defined by a need for respiratory support (assisted ventilation or nasal CPAP) and oxygen supplementation after 28 days of age

Exclusion Criteria:

  • Infants with multiple congenital anomalies or renal insufficiency
  • Infants with hypotension, hypertension, or on any cardiac medication
  • Infants with sepsis causing compromised clinical condition such as disseminated intravascular coagulopathy
  • Infants with contra-indications to diuretic therapy, such as significant electrolyte imbalance, or endocrine disease

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: 2
1 mg/kg by intravenous bolus injection
Experimental: 1
Furosemide
The dose of furosemide will be 1 mg/kg by intravenous bolus injection

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Cardiac chamber volume loading.
Time Frame: 4 hours after drug administration and 24 hours post recruitment
4 hours after drug administration and 24 hours post recruitment

Secondary Outcome Measures

Outcome Measure
Time Frame
Clinical cardio-respiratory stability (heart rate, blood pressure, respiratory rate, oxygen saturation, and oxygen requirement).
Time Frame: 4 hours after drug administration and 24 hours post recruitment
4 hours after drug administration and 24 hours post recruitment
Myocardial performance, cardiac input and output and pulmonary hemodynamics (echocardiograph exam).
Time Frame: 4 hours after drug administration and 24 hours post recruitment
4 hours after drug administration and 24 hours post recruitment
Changes in electrolyte balance, body weight and urine output.
Time Frame: 4 hours after drug administration and 24 hours post recruitment
4 hours after drug administration and 24 hours post recruitment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Patrick McNamara, MD, The Hospital for Sick Children, Toronto Canada

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2007

Primary Completion (Anticipated)

December 1, 2008

Study Completion (Anticipated)

June 1, 2009

Study Registration Dates

First Submitted

February 7, 2008

First Submitted That Met QC Criteria

February 19, 2008

First Posted (Estimate)

February 20, 2008

Study Record Updates

Last Update Posted (Estimate)

February 20, 2008

Last Update Submitted That Met QC Criteria

February 19, 2008

Last Verified

February 1, 2008

More Information

Terms related to this study

Other Study ID Numbers

  • 1000009083

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.