Document Detail


Blood volume and red cell mass in children with moderate and severe malaria measured by chromium-53 dilution and gas chromatography/mass spectrometric analysis.
MedLine Citation:
PMID:  19603467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Understanding blood volume changes in children with malaria is important for managing fluid status. Traditionally, blood/red cell volume measurements have used radioactive chromium isotopes. We applied an alternative approach, using non-radioactive chromium-53 labelling and mass spectrometry to investigate red cell volume (RCV) in Gabonese children with malaria. Nineteen children with malaria participated (10 severe, 9 moderately severe; ages 15 months to 7 years). Blood labelled with (53)Cr-chromate ex vivo was re-injected, then sampled 30 min later. Pre- and post-injection (53)Cr content were measured by gas chromatography/electron ionisation mass spectrometry of the chromium-trifluoroacetylacetone (TFA) chelate, calibrated against (50)Cr standards. Blood and red cell volumes were calculated from isotopic dilution in 15 of 19 children (in four, insufficient signal mitigated analysis). In this small pilot study, there were no significant differences between moderate and severe cases. Including all subjects, the mean RCV was reduced compared with predicted values (184 vs. 269 mL; p = 0.016) but blood volume, 71 +/- 33 mL/kg (normalised for weight), was close to predicted, approximately 77 mL/kg, commensurate with reduced haematocrit. Blood lactate concentration correlated negatively with RCV/weight (r = -0.56, p = 0.028), consistent with anaemia. In one case, sequential samples over 42 days gave an estimated rate of (53)Cr disappearance of 1.4%/day (equivalent half-life: 70 days). (53)Cr-labelling of red cells may be used to estimate blood and red cell volumes and can be used as an investigative tool in situations such as childhood diseases and resource-constrained settings. Although the red cell mass is depleted in malaria, the blood volume appears relatively well preserved.
Authors:
Derek C Macallan; Daniel A Abaye; Simone Dottin; Myriam Onanga; Maryvonne Kombila; Arnaud Dzeing-Ella; Peter G Kremsner; Sanjeev Krishna; Timothy Planche
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Rapid communications in mass spectrometry : RCM     Volume:  23     ISSN:  1097-0231     ISO Abbreviation:  Rapid Commun. Mass Spectrom.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-27     Completed Date:  2009-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8802365     Medline TA:  Rapid Commun Mass Spectrom     Country:  England    
Other Details:
Languages:  eng     Pagination:  2467-75     Citation Subset:  IM    
Copyright Information:
2009 John Wiley & Sons, Ltd.
Affiliation:
Division of Cellular and Molecular Medicine, Centre for Infection, St. George's Hospital Medical School, London SW17 0RE, UK. macallan@sgul.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Blood Volume*
Child
Child, Preschool
Chromium Isotopes / analysis*,  metabolism
Cohort Studies
Erythrocyte Volume*
Female
Gas Chromatography-Mass Spectrometry / methods*
Humans
Infant
Malaria / blood*,  metabolism,  pathology,  physiopathology*
Male
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Chromium Isotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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