Reperfusion after shock can trigger iron induced oxidative damage and therefore the influence of infusion fluids on the iron binding capacity of plasma may be important. Therefore in vitro the effects of adding fresh frozen plasma (FFP), pasteurized plasma protein solution (PPPS) and saline (NaCl), in volumes equivalent to 20 ml/kg infusions, to the plasma of 10 preterm and 10 term babies (g.a. 33.7±2.6 and 39.6±1.1 wks resp.) and 10 adults (age 32±10 y) were compared by measuring the transferrin iron binding antioxidant capacity (% inhibition of lipid peroxidation,%INH) and the level of non-protein-bound iron (NPBI, bleomycin method) in plasma.

In newborn plasma%INH, prior to infusion, was lower and the incidence of NPBI higher than in adults (table 1).%INH was negative in 50% and 20% of preterm and term babies resp. and in 0% of adults. FFP addition increased%INH in newborns to adult values and reduced the incidence of NPBI;%INH was now positive in all babies. However PPPS and NaCl did not influence%INH and incidence of NPBI in newborns, although%INH decreased slightly in adults.

Table 1
Full size table

Small volume FFP transfusions similarly to large volume exchange transfusions (Pediatrics 1992;90:200) may markedly improve iron binding capacity of plasma in newborns. The effect of infusion fluids on plasma antioxidant capacity should be considered in deciding which fluid is optimal in neonatal resuscitation.