Mercury Content of Blood Transfusions for Infants With Extremely Low Birth Weight

Elabiad, Mohamad T.; Hook, Rebecca E.

doi:10.1542/peds.2010-3712

Cited by 11 publications

(12 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The difference in metal concentrations between whole blood versus pRBCs may not be a trivial issue. In a recent study [66], 40 of 49 (82%) pRBC units had detectable Hg, compared to 16% of whole blood units reported here. In addition, 6.8% of the pRBC units exceeded the EPA reference dose on the day of transfusion [66].…”

Section: Discussioncontrasting

confidence: 62%

“…In a recent study [66], 40 of 49 (82%) pRBC units had detectable Hg, compared to 16% of whole blood units reported here. In addition, 6.8% of the pRBC units exceeded the EPA reference dose on the day of transfusion [66]. If the concentration of Hg were doubled in pRBCs prepared from whole blood reported here, 4 units (4%) would have exceeded the reference dose for Hg on the day of transfusion.…”

Section: Discussioncontrasting

confidence: 62%

“…These donors may have had a variety of exposures to substances including toxic heavy metals from environmental and occupational sources [8]. VLBWs are especially vulnerable to these toxic metal exposures [9][10][11][12][13][14]. The federal government has codified exposure levels acceptable to adult workers and to children exposed to environmental contaminants.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Toxic Metal Contamination of Banked Blood Designated for Neonatal Transfusion

Sundararajan¹,

Blatz²,

Dearborn³

et al. 2015

J Clin Toxicol

View full text Add to dashboard Cite

Objective: Very low birth weight (VLBW) infants frequently receive blood transfusions. We hypothesize that toxic metals in donor blood may pose a health risk with potential adverse neurologic effects on the developing brain of a vulnerable VLBW infant. Study design:Samples from 100 donor blood units were collected from a large urban hospital. Blood was analyzed for aluminum, arsenic, beryllium, cadmium, manganese, mercury, nickel, lead and polonium. The estimated upper limit of acceptable metal concentration in donor blood was calculated assuming a transfusion volume of 20 ml/kg and using either previously published acceptable intravenous doses or oral reference doses with a conservative estimate of 10% gastrointestinal absorption. Ingested mercury was assumed to be 95% absorbed.Results: Eight of the nine metals were detectable. Concentrations of arsenic, beryllium, cadmium, mercury and polonium were not of concern for any single blood transfusion. Concentrations of aluminum, manganese, nickel and lead exceeded the estimated upper limit of acceptable concentration in 5, 11, 4 and 26 units respectively. Of the 100 units, 31 had at least one toxic metal concentration high enough to pose a potential health risk.Conclusions: VLBW infants are exposed to heavy metals that are toxic from blood transfusion. The number of units with concerning levels of toxic metals was higher than expected. Neonatologists should be aware of this potential exposure to toxic metals from donor blood when decision is made to administer blood transfusion. Neurodevelopmental studies of toxic metal exposed infants from blood transfusion are warranted.

show abstract

Section: Discussioncontrasting

confidence: 62%

Section: Discussioncontrasting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Toxic Metal Contamination of Banked Blood Designated for Neonatal Transfusion

Sundararajan¹,

Blatz²,

Dearborn³

et al. 2015

J Clin Toxicol

View full text Add to dashboard Cite

show abstract

“…7,8 However, it is possible that the risks associated with red cell transfusion outweigh any potential benefit. The potential risks of blood transfusions include higher death rates 9 ; an increased iron or mercury load 10–12 ; continued risk for retinopathy of prematurity 13 ; and the association between necrotizing enterocolitis and transfusions. 14,15 …”

mentioning

confidence: 99%

International Survey of Transfusion Practices for Extremely Premature Infants

Guillén

Cummings

Bell

et al. 2012

Seminars in Perinatology

View full text Add to dashboard Cite

Our objective was to survey neonatologists regarding international practice of red cell transfusion thresholds for premature infants with <1000-g birth weight and/or <28-week gestation. An invitation to fill out an 11-question web-based survey was distributed to neonatologists through their professional societies in 22 countries. Physicians were asked about which specific factors, in addition to hemoglobin levels, influenced their decisions about transfusing premature infants. These factors included gestational age, postnatal age, oxygen need, respiratory support, reticulocyte count, and inotropic support. Physicians were presented with 5 scenarios and asked to identify hemoglobin cutoff values for transfusing infants with <1000-g birth weight and/or <28-week gestation. One thousand eighteen neonatologists responded: the majority were from the United States (67.5%), followed by Germany (10.7%), Japan (8.0%), the United Kingdom (4.9%), Spain (3.9%), Italy (2.6%), Colombia (0.6%), Argentina (0.4%), Canada (0.4%), Belgium (0.1%), and the Netherlands (0.1%). Half of the respondents (51.1%) reported having a written policy with specific red cell transfusion guidelines in their unit. Factors considered “very important” regarding the need to administer blood transfusions included degree of oxygen requirement (44.7%) and need for respiratory support (44.1%). Erythropoietin was routinely used to treat anemia by 26.0% of respondents. Delayed cord clamping or cord milking was practiced by 29.1% of respondents. The main finding was of a wide variation in the hemoglobin values used to transfuse infants, regardless of postnatal age. Step-wise increments in the median hemoglobin cutoffs directly paralleled an increase in the need for levels of respiratory support. In the first week of life, there was a wider range in the distribution of hemoglobin transfusion thresholds for infants requiring no respiratory support and full mechanical ventilation compared with the thresholds used in the second, third, and fourth weeks of life. An international survey using hypothetical scenarios shows that red blood cell transfusion practices vary widely among practicing neonatologists in participating countries.

show abstract

“…Preterm infants have increased vulnerability to neurotoxic agents due to an immature blood-brain barrier and ongoing developmental processes. Non-occupational exposure to Hg is primarily dietary in nature via bioaccumulation of MeHg in the aquatic food chain, but iatrogenic exposures in the form of dental amalgam 1-2 , thimerosal-containing vaccines 6 and blood transfusions 7-8 have been reported. We investigated Hg exposures of preterm infants in the Neonatal Intensive Care Unit (NICU) of a tertiary care institution.…”

mentioning

confidence: 99%