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Fresh-frozen plasma as a source of exogenous insulin-like growth factor-I in the extremely preterm infant

Journal article
Authors I. Hansen-Pupp
Eva Engström
Aimon Niklasson
A. C. Berg
V. Fellman
Chatarina Löfqvist
Ann Hellström
D. Ley
Published in J Clin Endocrinol Metab
Volume 94
Issue 2
Pages 477-482
ISSN 1945-7197
Publication year 2009
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Institute of Clinical Sciences
Pages 477-482
Language en
Links dx.doi.org/10.1210/jc.2008-1293
Keywords Blood Glucose/analysis, *Blood Transfusion/methods, Combined Modality Therapy, Gestational Age, Humans, *Infant, Extremely Low Birth Weight/blood, Infant, Newborn, Insulin-Like Growth Factor Binding Proteins/analysis/blood, Insulin-Like Growth Factor I/*administration & dosage/analysis/deficiency, Parenteral Nutrition, *Plasma/chemistry/physiology, Premature Birth/blood/*therapy, Treatment Outcome
Subject categories Medical and Health Sciences

Abstract

CONTEXT: Preterm birth is followed by a decrease in circulatory levels of IGF-I and IGF binding protein (IGFBP)-3, proteins with important neurogenic and angiogenic properties. OBJECTIVE: Our objective was to evaluate the effects of iv administration of fresh-frozen plasma (FFP) from adult donors on circulatory levels of IGF-I and IGFBP-3 in extremely preterm infants. DESIGN, SETTING, AND PATIENTS: A prospective cohort study was performed in 20 extremely preterm infants [mean (SD) gestational age 25.3 (1.3) wk] with clinical requirement of FFP during the first postnatal week. Sampling was performed before initiation of transfusion, directly after, and at 6, 12, 24, and 48 h after completed FFP transfusion. MAIN OUTCOME MEASURES: Concentrations of IGF-I and IGFBP-3 before and after transfusion of FFP were determined. RESULTS: FFP with a mean (SD) volume of 11 ml/kg (3.1) was administered at a median postnatal age of 2 d (range 1-7). Mean (SD) IGF-I and IGFBP-3 concentrations in administered FFP were 130 (39) and 2840 microg/liter (615), respectively. Immediately after FFP transfusion, mean (SD) concentrations of IGF-I increased by 133% from 11 (6.4) to 25 microg/liter (9.3) (P < 0.001) and IGFBP-3 by 61% from 815 (451) to 1311 microg/liter (508) (P < 0.001). Concentrations of IGF-I and IGFBP-3 remained higher at 6 (P < 0.001, P = 0.009) and 12 h (P = 0.017, P = 0.018), respectively, as compared with concentrations before FFP transfusion. Typical half-life of administrated IGF-I was 3.4 h for a 1-kg infant. CONCLUSION: Transfusion of FFP to extremely preterm infants during the first postnatal week elevates levels of IGF-I and IGFBP-3.

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