Anemia Treatment Among Patients Suffering From Left Ventricular Systolic Dysfunction Clinical Trial
The study Objective is to assess the clinical and echocardiographic changes of patients with systolic dysfunction receiving blood transfusion, with or without prior treatment with furosemide
More than 4 million patients receive a blood transfusion each year in the United States,
many of them suffer from congestive heart failure. The reported prevalence of anemia in CHF
is unknown, ranges widely from 4% to 70%, due to a lack of an established, consistent
definition of anemia in CHF.
Treating CHF patients with furosemide prior to blood transfusion became a common practice,
even though no randomize clinical trial had examine this issue. Nand et al. measured the
pulmonary capillary wedge pressures in 20 adults with chronic severe anemia (Hg <6 mg/dl)
and no systemic disease before and after transfusion of 700ml of whole blood. Ten of these
patients were treated with furosemide (40 mg intra-venous) immediately prior the
transfusion. The PCWP had increased significantly among patient who did not receive the
furosemide and decreased by 3.75% among patients in the furosemide group, although this
change was not was statistically significant. In another study, the same group of Nand et
al. measured the PCWP among 40 chronic anemia patients receiving blood transfusion. None of
the patients suffered from cardiopulmonary disease. The patients were randomly divided into
4 groups: the difference between the first 3 groups was the speed of the transfusion (2
ml/min, 5 ml/min and 10 ml/min). The fourth group patients were treated with 40 mg of
furosemide before the transfusion was given in a rate of 5 ml/min. The PCWP increased
significantly in the first 3 groups, with the rise being proportionately greater with faster
transfusions (15.8, 20.9 and 32.2% in groups A, B and C, respectively). In the furosemide
group, however, the PCWP decreased significantly by 21.7%.
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Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment