blood product transfusion

[nashwa]

When I give plasma or PRBC transfusion, is it necessary to give I.v frusemid after it to avoid volume overload in neonate in my nicu

[rehman_naveed]

No need for lasix routinely unless baby is having cardiac failure with volume overload condition

[Stefan Johansson]

I agree with @rehman_naveed.

No diuretics unless the baby is really unwell and have instable hemodynamics and renal function.

But, I believe people have different opinions on this. For example, I was taught to give diuretics after blood transfusions  (when the goal is to increase Hb/EVF)

[wackdi]

Hi, I would absolutely agree with Stefan and Naveed!

 

A good randomized placebo-controlled trial showed no clinical relevant changes in haemodynamics in preterm infants. The only significant change was an increase in FiO2 from 0.27 to 0.29.

 

http://www.ncbi.nlm.nih.gov/pubmed/21784442

 

The article gives you even a good overview on the topic.

 

Greetings Dirk

[nashwa]

Okey, if there is ascites associated with liver disease, can I give plasma and iv lasix after or no

[rehman_naveed]

Now its a different scenario. Ascities with liver disease, you need to check for albumin and in case you need to give plasma , donot give lasix. But it all depends what you want to achive, do you want to raise plasma oncotic presure so as to diurese the baby as baby having oliguria, in such a case i will go ahead with albumin rather than plasma and yes this with lasix. If it is just to replace clotting factors then no with lasix only plasma alone. I hope this will help.

[nashwa]

In case of baby with liver dis and ascities, when give plasma...oncotic pr increased and will shift fluid from interstitial and 3rd space , so I give lasix to get ride of excess fluid in intra vascular by diuresis .....is that true or what

[rehman_naveed]

The scenario you describe is usually achieved by giving albumin rather than plasma. And also this is done in severe anasarca with oliguria to get rid of extra fluids but this is usually transient to help baby respiratory status improved. Having said that in capillary leak cases secondary to sepsis no role of albumin only plasma will help and stay longer intravascularly.

[nashwa]

Why in albumin intake , I give I've lasix after and in plasma transfusion not

[rehman_naveed]

I dont know exact reason but seems like albumin moves lot of fluids from 3rd space to intavascular compartment endagering cardiac failure and pulmonary edema. While plasma does the same but to lesser extent

[drrameshkumarmuhilai]

Not necessarily to give frusemide unless indicated , like signs of volume over load