Acta Pzdiatr Scand 64: 3 10-3 14, 1975
EXCHANGE TRANSFUSIONS WITH CONCENTRATED ACD-BLOOD 11. Effects
Bilirubin, Totul Protein, Chloride, Phosphate, Calcium, Magnesium und Potassium
OH
A. KREUGER f;rorn rhe Deportment of’Puediutrics unci (he Blood Center, University HoApitul, U,vpsulu, Sweden
ABSTRACT. Kreuger, A. (Department of Paediatrics, University Hospital, Uppsala, Sneden). Exchange transfusions with concentrated ACD-blocd. 11. Effects on bilirubin, total protein, chloride, phosphate, calcium, magnesium and potassium. Acta Paediatr Scand, 64:310, lWS.-During ten exchange transfusions with ACD-blood (NIH, sol. B), newborn infants’ bilirubin, plasma protein and electrolyte gain or loss were studied quantitatively. The loss of bilirubin was closely correlated to the pre-exchange bilirubin concentration. On the average, there was a significant loss of plasma chloride of 3.21 mmnl per kg bodyweight. There were no significant gains or losses of plasma protein or sodium, potassium, magnesium and calcium of whole blood during the ET. There was a calculated significant inflow of whole blood calcium from the extravascular space of 0.02 mmol per kg bodyweight together with a calculated significant increase of plasma phosphate of 0.06 mmol per kg bodyweight. KEY WORDS: Exchange transfusions, newborn
In a preceding paper (4) red cell measurements of the given and removed blood during ten exchange transfusions (ET) were described. In the present investigation of the same patients at the same ETs the total amounts of bilirubin, total protein, chloride and phosphate in plasma gained or lost were determined, as well as the sodium, potassium, calcium and magnesium content of whole blood. METHODS Chloride was determined by titration with mercury nitrate; sodium, potassium and calcium by flame photometry; magnesium wab determined by atomic adsorption and phosphate according to Gomori ( 3 ) . The plasma protein concentration was determined by its ultraviolet light absorption (7). Bilirubin was determined according to Michaelsson ( 5 ) . Determinations on whole blood were made after freezing and thawing of the blood. Acta P z d i a t r Scand 64
Calculations A t each exchange transfusion the total amount of a blood constituent given or removed was calculated from the volumes reported in the preceding paper (4) and the concentrations determined in the present investigation. For comparison the. values are given per kg bodyweight. The predicted blood and plasma volumes of the infants before and after the ET (4) were used for the calculations of their total blood and total plasma content of the constituents studied respectively.
RESULTS Table I shows the concentrations and Table 2 the total amounts of bilirubin, total protein, chloride, phosphate, calcium, magnesium, potassium and sodium in the children’s plasma or whole blood before and after the ET and in the administered and removed blood. All total amounts are here given per kg bodyweight of the infant.
Exchange transfusions with ACD-blood. ZZ
3 11
Table 1. Concentrations of bilirubin, total protein, chloride and phosphate of plasma and concentrations of sodium, potassium, calcium and magnesium of whole blood Mean values and S.D. of ten exchange transfusions Conc. P-Bil P-Protein P-CI P-Phosph ate B-Na B-K B-Ca B-Mg
Infant before
Given blood 10.4k8.6" 55 fS 70.8 f4.4" 1.8fO.Y" 82.2f4.9 33.5f3.1" 1.1f0.2 1.8f0.2
pmolll
225.7f 162.5"
g/ I
51 t8
mmol/l mmol/l mmol/l mmol/l mmolil mmol/l
108.5f 4 . P 1.8f0.4" 78.5f11.9 38.5 f6 .2a 1.2f0.4 1.9f0.3
Removed blood
Infant after
143.6f106.0
128.3f90.6
53+5
50f8
101.0k4.0 2. I t 0 . 4 84.3f6.9 35.553. I 1.2t0.3 1.8f0.2
100.6f4.1 2.2f0.4 83.726.0 33.7f4.3 1.3k0.3 1.8f0.3
" Significant difference (see text) of infant before/infdnt after or given blood/removed blood.
Bilirubin Before E T the infants' plasma bilirubin concentrations varied between 58 and 482 pmol/l and the plasma bilirubin contents were calculated to vary between 2.57 and 20.01 pmol per kg bodyweight. The bilirubin mean concentration of the plasma decreased significantly from 225.7 to 128.3 pmol/l during the E T (Table I , ~ ~ 0 . 0 2 5On ) . the average the infants' plasma pool was calculated to contain 10.21 pmol bilirubin before the ET, 0.77 pmol were added and 12.52 pmol removed by the ET (Table 2). After the E T the plasma pool was calculated to contain on average 5.81 pmol bilirubin indicating that on average 7.35 pmol had been formed or transferred to the plasma from other compartments during the E T (Table 2). This in-
crease differed significantly from zero, p
EXCHANGE TRANSFUSIONS WITH CONCENTRATED ACD-BLOOD 11. Effects
Bilirubin, Totul Protein, Chloride, Phosphate, Calcium, Magnesium und Potassium
OH
A. KREUGER f;rorn rhe Deportment of’Puediutrics unci (he Blood Center, University HoApitul, U,vpsulu, Sweden
ABSTRACT. Kreuger, A. (Department of Paediatrics, University Hospital, Uppsala, Sneden). Exchange transfusions with concentrated ACD-blocd. 11. Effects on bilirubin, total protein, chloride, phosphate, calcium, magnesium and potassium. Acta Paediatr Scand, 64:310, lWS.-During ten exchange transfusions with ACD-blood (NIH, sol. B), newborn infants’ bilirubin, plasma protein and electrolyte gain or loss were studied quantitatively. The loss of bilirubin was closely correlated to the pre-exchange bilirubin concentration. On the average, there was a significant loss of plasma chloride of 3.21 mmnl per kg bodyweight. There were no significant gains or losses of plasma protein or sodium, potassium, magnesium and calcium of whole blood during the ET. There was a calculated significant inflow of whole blood calcium from the extravascular space of 0.02 mmol per kg bodyweight together with a calculated significant increase of plasma phosphate of 0.06 mmol per kg bodyweight. KEY WORDS: Exchange transfusions, newborn
In a preceding paper (4) red cell measurements of the given and removed blood during ten exchange transfusions (ET) were described. In the present investigation of the same patients at the same ETs the total amounts of bilirubin, total protein, chloride and phosphate in plasma gained or lost were determined, as well as the sodium, potassium, calcium and magnesium content of whole blood. METHODS Chloride was determined by titration with mercury nitrate; sodium, potassium and calcium by flame photometry; magnesium wab determined by atomic adsorption and phosphate according to Gomori ( 3 ) . The plasma protein concentration was determined by its ultraviolet light absorption (7). Bilirubin was determined according to Michaelsson ( 5 ) . Determinations on whole blood were made after freezing and thawing of the blood. Acta P z d i a t r Scand 64
Calculations A t each exchange transfusion the total amount of a blood constituent given or removed was calculated from the volumes reported in the preceding paper (4) and the concentrations determined in the present investigation. For comparison the. values are given per kg bodyweight. The predicted blood and plasma volumes of the infants before and after the ET (4) were used for the calculations of their total blood and total plasma content of the constituents studied respectively.
RESULTS Table I shows the concentrations and Table 2 the total amounts of bilirubin, total protein, chloride, phosphate, calcium, magnesium, potassium and sodium in the children’s plasma or whole blood before and after the ET and in the administered and removed blood. All total amounts are here given per kg bodyweight of the infant.
Exchange transfusions with ACD-blood. ZZ
3 11
Table 1. Concentrations of bilirubin, total protein, chloride and phosphate of plasma and concentrations of sodium, potassium, calcium and magnesium of whole blood Mean values and S.D. of ten exchange transfusions Conc. P-Bil P-Protein P-CI P-Phosph ate B-Na B-K B-Ca B-Mg
Infant before
Given blood 10.4k8.6" 55 fS 70.8 f4.4" 1.8fO.Y" 82.2f4.9 33.5f3.1" 1.1f0.2 1.8f0.2
pmolll
225.7f 162.5"
g/ I
51 t8
mmol/l mmol/l mmol/l mmol/l mmolil mmol/l
108.5f 4 . P 1.8f0.4" 78.5f11.9 38.5 f6 .2a 1.2f0.4 1.9f0.3
Removed blood
Infant after
143.6f106.0
128.3f90.6
53+5
50f8
101.0k4.0 2. I t 0 . 4 84.3f6.9 35.553. I 1.2t0.3 1.8f0.2
100.6f4.1 2.2f0.4 83.726.0 33.7f4.3 1.3k0.3 1.8f0.3
" Significant difference (see text) of infant before/infdnt after or given blood/removed blood.
Bilirubin Before E T the infants' plasma bilirubin concentrations varied between 58 and 482 pmol/l and the plasma bilirubin contents were calculated to vary between 2.57 and 20.01 pmol per kg bodyweight. The bilirubin mean concentration of the plasma decreased significantly from 225.7 to 128.3 pmol/l during the E T (Table I , ~ ~ 0 . 0 2 5On ) . the average the infants' plasma pool was calculated to contain 10.21 pmol bilirubin before the ET, 0.77 pmol were added and 12.52 pmol removed by the ET (Table 2). After the E T the plasma pool was calculated to contain on average 5.81 pmol bilirubin indicating that on average 7.35 pmol had been formed or transferred to the plasma from other compartments during the E T (Table 2). This in-
crease differed significantly from zero, p
