NoBlood

Journal:
1: Pediatr Pulmonol. 2005 Mar;39(3):257-61

Publisher:
Wiley-Liss, Inc., A Wiley Company

Link:
http://tinyurl.com/3mf4b

Contact:
Keith J. Collard (keith.collard@plymouth.ac.uk)
Correspondence to Keith J. Collard, Department of Medical Sciences, School of Health Professions, University of Plymouth, Millbrook House Site, Millbrook Lane, Topsham Road, Exeter EX2 6ES, UK

Title:
Blood transfusion and pulmonary lipid peroxidation in ventilated premature babies

Funded by:
NHS Executive South West Region
London Law Trust

Key Words
oxidative damage • blood transfusion • lung • bronchoalveolar lavage • bronchopulmonary dysplasia

Abstract
Urinary malondialdehyde (MDA; a biochemical marker of lipid peroxidation) is increased following the receipt of blood transfusions in premature babies. This indicates an increased level of oxidative damage somewhere in the body. The aim of this study was to determine whether the lung may be a site of increased oxidative damage following blood transfusions. This was achieved by examining the relationship between blood transfusion and levels of MDA in bronchoalveolar lavage (BAL) fluid from ventilated premature babies. The study was a retrospective analysis of data obtained from a group of 42 ventilated premature babies of less than 32 weeks' gestation. Twenty-seven babies received blood transfusions, and 9 received at least one transfusion during the first week of life when daily BAL samples were being taken. Pulmonary epithelial lining fluid (ELF) was sampled by BAL daily during the first week of life and weekly thereafter. MDA was measured by an established high performance liquid chromatography (HPLC) technique. There was a significant positive correlation between volume of blood transfusions received and peak and mean ELF MDA levels (r = 0.810, peak; r = 0.740, mean; n = 21). During the first week of life, when daily samples were being taken, the mean ELF MDA level after blood transfusion (1.829 M; SE, 0.529) was significantly greater than before transfusion (0.928 M; SE, 0.297) (n = 9). In babies who received 2 transfusions within the first week (n = 5), the MDA level was elevated further following the second transfusion (2.825 M; SE, 0.346). The results of this study indicate that pulmonary oxidative damage increases after the receipt of blood transfusions. Babies receiving blood transfusions show a greater incidence of pulmonary oxidative stress and poor clinical outcome. This may simply reflect that the sickest babies are those most in need of blood transfusion, and that there is no causal relationship. However, the possibility of a causal relationship between blood transfusions and oxidative damage exists and should be investigated. Pediatr Pulmonol. 2005; 39:257-261. © 2005 Wiley-Liss, Inc.

Received: 22 July 2004; Revised: 3 November 2004; Accepted: 4 November 2004
Digital Object Identifier (DOI)