Division of Neonatology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee.
Am J Perinatol. 2013 Oct;30(9):765-70. doi: 10.1055/s-0032-1332803. Epub 2013 Jan 15.
Our objective was to evaluate the levels of lead in blood transfusions for extremely low-birth-weight (ELBW) infants and how they compare with lead levels suspected of causing neurotoxicity.
This prospective cohort included infants with a birth weight ≤ 1000 g. The quantity of transfused lead was calculated based on transfused volume and packed red blood cell (PRBC) unit lead levels. The results were compared with the exposure reference.
Thirty-seven infants (birth weight 736 ± 157 g, gestational age 25.5 ± 1.5 weeks) received 322 transfusions from 47 PRBC units with 6.5 ± 3.5 different units used to complete all transfusions per infant. Lead was detected in all units. The average lead level in a PRBC unit was 18.3 ± 10.4 µg/L. Of 322 transfusions, 139 (43%) had lead volumes that exceeded the exposure reference. All infants received at least one transfusion with a lead volume exceeding the daily reference dose equivalent, and four infants (11%) received several transfusions with a cumulative lead volume exceeding the weekly reference dose.
Blood transfusions are a potential source of lead for ELBW infants with unknown safety implications in this critical time of brain development.
我们的目的是评估极低出生体重（ELBW）婴儿输血中的铅含量，并将其与疑似引起神经毒性的铅含量进行比较。
本前瞻性队列研究纳入了出生体重≤1000g 的婴儿。根据输注量和浓缩红细胞（PRBC）单位的铅含量计算输注的铅量。将结果与暴露参考值进行比较。
37 名婴儿（出生体重 736±157g，胎龄 25.5±1.5 周）接受了 322 次输血，来自 47 个 PRBC 单位，每个婴儿平均使用 6.5±3.5 个不同的单位完成所有输血。所有单位均检测到铅。PRBC 单位的平均铅含量为 18.3±10.4μg/L。在 322 次输血中，有 139 次（43%）的铅量超过暴露参考值。所有婴儿至少接受了一次超过每日参考剂量当量的输血，4 名婴儿（11%）接受了几次累积铅量超过每周参考剂量的输血。
输血是 ELBW 婴儿铅的潜在来源，在大脑发育的这个关键时期，其安全性尚不清楚。
