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Blood volume and red cell mass in children with moderate and severe malaria measured by chromium‐53 dilution and gas chromatography/mass spectrometric analysis
Author(s) -
Macallan Derek C.,
Abaye Daniel A.,
Dottin Simone,
Onanga Myriam,
Kombila Maryvonne,
DzeingElla Arnaud,
Kremsner Peter G.,
Krishna Sanjeev,
Planche Timothy
Publication year - 2009
Publication title -
rapid communications in mass spectrometry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.528
H-Index - 136
eISSN - 1097-0231
pISSN - 0951-4198
DOI - 10.1002/rcm.4058
Subject(s) - chemistry , chromatography , dilution , volume (thermodynamics) , chromium , isotope dilution , gas chromatography , analytical chemistry (journal) , environmental chemistry , mass spectrometry , organic chemistry , thermodynamics , physics
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, ∼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. Copyright © 2009 John Wiley & Sons, Ltd.