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Effect of blood transfusions on oxidative stress in preterm infants
  1. C Dani1,
  2. E Martelli1,
  3. G Bertini1,
  4. M Pezzati1,
  5. M Rossetti2,
  6. G Buonocore3,
  7. P Paffetti3,
  8. F F Rubaltelli1
  1. 1Division of Neonatology, Careggi University Hospital, Florence, Italy
  2. 2Central Laboratory of Chemical-Clinical Analysis, Careggi University Hospital
  3. 3Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy
  1. Correspondence to:
    Professor Dani
    Division of Neonatology, Careggi University Hospital, University of Florence School of Medicine, Viale Morgagni, 85 Firenze, Italy; cdani.unifi.It


Objective: To confirm the increase in non-transferrin bound iron (NTBI) after packed red cell (PRC) transfusion and to evaluate the association with increased oxidative stress in preterm infants.

Method: Twenty healthy preterm infants (gestational age 28.2 (2.2) weeks; birth weight 1047 (230) g), who required blood transfusion for anaemia of prematurity were prospectively studied. Serum concentrations of NTBI, total hydroperoxides (TH), and protein SH groups, and plasma total radical trapping antioxidant capability (TAC) were measured within three hours before and after PRC transfusion. The infants were transfused with 38.6 (23) ml PRCs over 5.8 (1.0) hours, at a mean age of 43.3 (25.1) days.

Results: After PRC transfusion, haemoglobin concentration increased from 9.2 (1.1) to 14.6 (1.5) g/l. Mean plasma NTBI concentration after transfusion was significantly higher (0.43 (0.45) v 2.03 (1.31) μmol/l; p  =  0.001), while plasma concentrations of TH (212.3 (42.2) v 214.7 (66.3) Carr units/l) and protein SH groups (317.5 (38.8) v 353.8 (57.4) μmol/), and TAC (256.3 (36.1) v 267.1 (42.4) μmol HClO/ml) remained unchanged.

Conclusion: For three hours after PRC transfusion, plasma NTBI is significantly increased in preterm infants, but this is not associated with significant changes in oxidative stress.

  • CLD, chronic lung disease, NTBI, non-transferrin bound iron
  • PRC, packed red cell
  • ROP, retinopathy of prematurity
  • TAC, total radical trapping antioxidant capability
  • TH, total hydroperoxides
  • blood transfusion
  • iron
  • oxidative stress
  • infant

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