III. THE FATE OF CITRATE IN ERYTHROBLASTOTIC INFANTS TREATED WITH EXCHANGE TRANSFUSION 12

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Abstract
Exchange transfusions were carried out on one mongoloid newborn with no symptoms of liver damage or erythroblastosis and on 8 newborns with erythroblastosis fetalis. Serial studies done on blood removed from these infants indicated that the citrate contained in the added blood was rapidly metabolized by the infant. Admn. of Ca gluconate interferes with the rate of citrate removal from the blood stream. Endogenous Ca levels were observed to rise on the addition of citrated blood. Total base, citrate, P, Ca and total protein levels were normal 1 hr. after the completion of the transfusion. Erythroblastotic infants showed impaired ability to remove citrate as compared to the infant with no liver damage. The liver, kidneys, musculature and bone appear to remove or neutralize the effect of high citrate levels in the blood stream.