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


METHODS
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.


METHODS
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.


CONCLUSIONS
Transfusion of FFP to extremely preterm infants during the first postnatal week elevates levels of IGF-I and IGFBP-3.
Hansen-Pupp
Ingrid
I
Division of Pediatrics, Department of Clinical Sciences Lund, Lund University Hospital, 221 85 Lund, Sweden. ingrid.pupp@skane.se
Engström
Eva
E
Niklasson
Aimon
A
Berg
Ann-Cathrine
AC
Fellman
Vineta
V
Löfqvist
Chatarina
C
Hellström
Ann
A
Ley
David
D
D001786:Blood Glucose / Q000032:analysis; D001803:Blood Transfusion / Q000379:methods; D003131:Combined Modality Therapy; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000097:blood; D007231:Infant, Newborn; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins / Q000032:analysis / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000008:administration & dosage* / Q000032:analysis / Q000172:deficiency; D010288:Parenteral Nutrition; D010949:Plasma / Q000737:chemistry / Q000502:physiology; D047928:Premature Birth / Q000097:blood / Q000628:therapy*; D016896:Treatment Outcome
D001786:Blood Glucose; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I