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Related Experiment Videos

Parathyroid hormone secretion during exchange transfusion.

R D Milner, J S Woodhead

    Archives of Disease in Childhood
    |April 1, 1975
    PubMed
    Summary
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    Exchange transfusion with acid-citrate and dextrose (ACD) blood in infants with hemolytic disease causes a significant increase in parathyroid hormone (PTH) secretion, likely due to citrate-induced hypocalcemia. Heparinized blood transfusions did not produce this effect.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Hematology
    • Biochemistry

    Background:

    • Infants with hemolytic disease often require exchange transfusions.
    • Blood anticoagulants like acid-citrate and dextrose (ACD) and heparin are used during transfusions.
    • The metabolic effects of these anticoagulants on infant physiology are not fully understood.

    Purpose of the Study:

    • To compare the effects of ACD and heparinized blood on plasma concentrations of calcium, phosphate, citrate, albumin, and parathyroid hormone (PTH) in infants undergoing exchange transfusion.
    • To investigate the impact of citrate load on PTH secretion and mineral balance.

    Main Methods:

    • Plasma levels of calcium, phosphate, citrate, albumin, and PTH were measured in infants before, during, and after exchange transfusion.

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  • Infants received either ACD-anticoagulated or heparinized donor blood.
  • Correlations between pretransfusion PTH, phosphate, and postnatal age were analyzed.

    • Main Results:

    • ACD blood transfusion led to a twelvefold increase in plasma citrate but no immediate changes in infant plasma calcium, phosphate, or PTH.
    • Heparinized blood transfusion did not alter plasma concentrations of measured substances.
    • ACD blood transfusion resulted in a net loss of calcium, phosphate, and albumin, and a greater net loss of PTH compared to heparinized blood.
    • A rise in plasma PTH was observed 3 hours post-ACD transfusion, but not post-heparin transfusion.

    Conclusions:

    • Transfusion with ACD blood increases parathyroid hormone (PTH) secretion in infants, likely due to citrate-induced hypocalcemia.
    • Heparinized blood is a safer alternative regarding immediate metabolic disturbances and PTH secretion during exchange transfusion.
    • Careful monitoring of mineral balance and PTH is recommended during exchange transfusions with ACD blood.