Furosemide supplemented blood transfusion in cases of chronic severe anemia

Pulmonary capillary 'wedge' pressures (PCWP) were measured in 20 adult cases of chronic severe anemia (CSA) before and after transfusion of 700 ml of whole blood at a rate of 5 ml/min. The cases were randomly divided into 2 groups of 10 cases each. Group II also received 40 mg of furosemide immediately before the start of transfusion. The majority of the cases had hemoglobin values less than 4 g% and serum albumin values less than 2.5 g%. Pretransfusion intracardiac pressures were normal in all the cases. Following blood transfusion (BT), appreciable rises (p less than 0.001) in hemoglobin and arterial and venous oxygen saturation were observed. PCWP increased significantly after BT in Group I (p less than 0.001). Although it decreased by 3.75% in Group II, this was not statistically significant (p greater than 0.05). This study implies that a blood transfusion of 700 ml, given at a speed of 5 ml/min in patients with CSA, results in sufficient hemodynamic stress to cause a significant rise in PCWP, and that this is completely prevented by simultaneous administration of 40 mg of furosemide.