Related Experiment Videos
Lead exposure from blood transfusion to premature infants
C F Bearer1, M A O'Riordan, R Powers
1Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
Insights
Premature infants receiving blood transfusions are exposed to lead, potentially exceeding safe levels. Using packed red blood cells with lower lead concentrations can effectively reduce this exposure.
Area of Science:
- Neonatal Medicine
- Toxicology
- Pediatric Hematology
Background:
- Premature infants are vulnerable to environmental toxins.
- Blood transfusions are common in neonatal intensive care units.
- Lead exposure is a significant health concern for infants.
Purpose of the Study:
- To quantify lead exposure in premature infants via blood transfusions.
- To assess the impact of transfusions on infant blood lead levels.
- To establish safe lead concentration limits for transfusion products.
Main Methods:
- Measured blood lead concentrations in 19 premature infants.
- Analyzed lead levels in donor packed red blood cells from 79 transfusions.
- Correlated transfusion volume and donor lead concentration with infant blood lead changes.
Main Results:
- Infants received an average of 4.2 transfusions, with a mean lead dose of 1.56 microg/dL per transfusion.
- Total lead dose over 4 weeks was 4.0 microg/kg.
- Packed red blood cells with lead concentrations ≥5 microg/dL elevated infant blood lead levels.
Conclusions:
- Lead exposure from transfusions in premature infants surpasses acceptable daily intake.
- Elevated post-transfusion blood lead concentrations pose a risk.
- Using packed red blood cells with lead <3.3 microg/dL is a cost-effective strategy to minimize exposure.
Objective:
The objective of this study was to determine the exposure of premature infants to lead from blood transfusions.
Study Design:
Blood lead concentrations were determined for 19 very premature infants at the time of admission, at 4 weeks of life, and before and after transfusions and in the donor packed red blood cells of 79 transfusions.
Results:
The number of transfusions per patient was 4. 2 +/- 2.8 (mean +/- SD) with 15.7 +/- 1.9 mL/kg packed red blood cells for a lead dose of 1.56 +/- 1.77 microg/dL. The total dose of lead from these transfusions over the 4-week period was 4.0 +/- 2.8 microg/kg (range, 0.9-10.6 microg/kg). Increases in post-transfusion blood lead concentration were linear with doses higher than 1.5 microg/dL. Packed red blood cells with a blood lead concentration of > or = 5 microg/dL resulted in an elevated post-transfusion blood lead concentration in some infants.
Conclusions:
The lead exposure to these infants through blood transfusion exceeds the acceptable daily intake values for lead and may result in unacceptably high post-transfusion blood lead concentrations. Use of packed red blood cells with lead concentrations <3.3 microg/dL is one cost-effective means to reduce exposure.