title: The capacity of different infusion fluids to lower the prooxidant activity of plasma iron: an important factor in resuscitation?
abstract: BACKGROUND
  Prooxidant activity of non-protein-bound iron (NPBI) is an important contributor to reactive oxygen species-induced injury after the resuscitation of critically ill patients. Plasma NPBI occurs in critically ill adults, children, and newborn babies, who often require resuscitation. The ability of the resuscitation fluids to bind iron and lower the patients' NPBI levels in vitro has not previously been studied.
  
  
  METHODS
  In an in vitro model, highly iron-saturated cord blood plasma from 10 preterm and 10 term babies was mixed with FFP, pasteurized plasma protein solution, and 0.9-percent saline. Plasma from 10 healthy adult volunteers was used as a control. Before and after the mixing with any resuscitation fluid, NPBI levels and ceruloplasmin iron-oxidizing and transferrin iron-binding antioxidant capacities were measured.
  
  
  RESULTS
  After the in vitro mixing with FFP, the incidence and concentration of NPBI were markedly decreased and the iron-binding antioxidant capacity was increased in the plasma of the preterm and term babies. Being mixed with pasteurized plasma protein solution and 0.9-percent saline did not influence the iron-binding antioxidant capacity of newborn babies' plasma. In the control plasma, results were not changed after the mixing with any resuscitation fluid. In every group, the iron-oxidizing antioxidant capacity was not changed after the mixing with any fluid.
  
  
  CONCLUSIONS
  Iron-induced oxidative tissue damage may be influenced by resuscitation fluids. In the ongoing debate over the choice of crystalloid or colloid resuscitation fluids, the influence of each fluid on the patient's antioxidant capacity warrants more attention.
authors: Neonatal Unit, Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors: R M
authors: RM
authors: Moison
authors: F E
authors: FE
authors: Bloemhof
authors: J A
authors: JA
authors: Geerdink
authors: A J
authors: AJ
authors: de Beaufort
authors: H M
authors: HM
authors: Berger
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D007501:Iron / Q000097:blood* / Q000378:metabolism; D010084:Oxidation-Reduction; D011247:Pregnancy; D011485:Protein Binding; D012151:Resuscitation
chemical_list: D000975:Antioxidants; D007501:Iron