Prophylactic furosemide to prevent transfusion-associated circulatory overload: a randomized controlled study in rats.

Autor: Klanderman RB; Department of Intensive Care, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands. r.b.klanderman@amsterdamumc.nl.; Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands. r.b.klanderman@amsterdamumc.nl.; Department of Anesthesiology, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands. r.b.klanderman@amsterdamumc.nl., Bosboom JJ; Department of Anesthesiology, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., Veelo DP; Department of Anesthesiology, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., Roelofs JJTH; Department of Pathology, Amsterdam UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., de Korte D; Department of Product and Process Development, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands., van Bruggen R; Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands., Vogt L; Department of Nephrology, Amsterdam UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., van Buul JD; Department of Molecular Hematology, Molecular Cell Biology Lab, Sanquin Research and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands., Hollmann MW; Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands.; Department of Anesthesiology, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., Vroom MB; Department of Intensive Care, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., Juffermans NP; Department of Intensive Care, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands.; Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., Geerts BF; Department of Anesthesiology, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands., Vlaar APJ; Department of Intensive Care, Amsterdam , UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands.; Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC-AMC, University of Amsterdam, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2022 Jul 15; Vol. 12 (1), pp. 12127. Date of Electronic Publication: 2022 Jul 15.
DOI: 10.1038/s41598-022-16465-z
Abstrakt: Transfusion-associated circulatory overload (TACO) is the leading cause of transfusion related morbidity and mortality. The only treatment is empirical use of furosemide. Our aim was to investigate if furosemide can prevent TACO. A randomized controlled trial was performed using a previously validated two-hit rat model for TACO. Volume incompliance was induced (first hit) in anemic, anesthetized Lewis rats. Rats were randomized to placebo, low-dose (5 mg kg -1 ) or high-dose (15 mg kg -1 ) furosemide-administered prior to transfusion (second-hit) and divided over two doses. Primary outcome was change in left-ventricular end-diastolic pressure (∆LVEDP) pre- compared to post-transfusion. Secondary outcomes included changes in preload, afterload, contractility and systemic vascular resistance, as well as pulmonary outcomes. Furosemide treated animals had a significantly lower ∆LVEDP compared to placebo (p = 0.041), a dose-response effect was observed. ∆LVEDP in placebo was median + 8.7 mmHg (IQR 5.9-11), + 3.9 (2.8-5.6) in the low-dose and 1.9 (- 0.6 to 5.6) in the high-dose group. The effect of furosemide became apparent after 15 min. While urine output was significantly higher in furosemide treated animals (p = 0.03), there were no significant changes in preload, afterload, contractility or systemic vascular resistance. Furosemide rapidly and dose-dependently decreases the rise in hydrostatic pulmonary pressure following transfusion, essential for preventing TACO.
(© 2022. The Author(s).)
Databáze: MEDLINE
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