PEDIATRICS Vol. 52 No. 5 November 1973, pp. 716-718
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Carboxyhemoglobin Exchange Between Donors and Recipients of Blood Transfusions

Stephen R. Kandall M.D.1, Stephen A. Landaw M.D., Ph.D.1, and M. Michael Thaler M.D.1

1 Department of Pediatrics, University of California, San Francisco, California, Donner Laboratory, University of California, Berkeley, California

The potential toxicity of carbon monoxide in transfused blood has received relatively little attention. Ayres et al.1 demonstrated that a rise in carboxyhemoglobin (COHb) percent saturation from approximately 1% to 5% to 10% causes a notable decrease in the arterial and mixed venous blood oxygen tension in normal adults. Engel et al.2 noted that COHb in newborn infants with hemolytic disease could be altered with exchange blood transfusions. When respiratory distress occurs in such infants, high COHb in transfused blood may, therefore, reduce tissue oxygenation to dangerously low levels.

The relationship between COHb in donor blood and in recipients of exchange blood transfusions was examined in 15 infants with neonatal hyperbilirubinemia not associated with pulmonary deficiency.