CLINICAL CHEMISTRY, Vol. 61, No. 10, Supplement, 2015 S183 Pediatric/Fetal Clinical Chemistry Wednesday, July 29, 9:30 am – 5:00 pm Wednesday, July 29, 2015 Poster Session: 9:30 AM - 5:00 PM Pediatric/Fetal Clinical Chemistry B-208 Effect of Multiple Transfusions on Lipid Peroxidation in Preterm Infants Z. A. Unkar, H. Bilgen, A. Yaman, A. Memisoglu, H. Ozdemir, O. Sirikci, G. Haklar, E. Ozer. Marmara University, Istanbul, Turkey Multiple blood transfusions are commonly used in the course of neonatal intensive care unit (NICU) stay in very low birth weight (VLBW) infants. The number of transfusions received has been associated with the development of prematurity complications (retinopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular leukomalacia). The severity of the illness can increase the number of transfusions required, resulting in iron overload which may increase the release of reactive oxygen species. The aim of this study was to determine the relationship between blood transfusions, ferritin levels and oxidative stress in preterm infants. Preterm infants (n=23, gestational age 28.43±3.50 weeks; birth weight 1180±471g) admitted to the NICU were enrolled. Five of them (21.7%) were never transfused, while 10 cases (43.5%) were transfused less than 5 times, 2 cases (8.7%) 6-10 times, and 6 cases (26.1%) were transfused more than 10 times. Venous blood samples were taken when they were at least 20 days of age in a period free of infection according to clinical signs and laboratory test results. Serum malondialdehyde (MDA) levels were measured by HPLC (Ultimate 3000, Thermo Dionex, USA) with a flourescence detector. Within-run precision values were 1.8-5.5% and between-run precision values were 6.5-9% for 0.40-1.55 µmol/L MDA, according to manufacturer’s claim. The lower detection limit was 0.02 μmol/L. Serum iron and iron binding capacity were measured colorimetrically (Cobas 8000 Modular Analytics, Roche Diagnostics, Germany). Ferritin levels were measured with an immunometric test with electrochemiluminescence detection (Modular Analytics E170, Roche Diagnostics, Germany). There was a significant difference in serum ferritin levels between transfused (median: 457ng/mL, range:108-2717) and non-transfused (median: 203ng/mL, range:102-268) infants (P=0.017). There was a statistically significant correlation between serum ferritin and MDA levels (P<0.001; r=0.693). Also, the correlation between the number of transfusions and serum ferritin levels was statistically significant (P=0.016; r=0.558). Serum MDA levels were significantly higher in infants with serum ferritin levels >450 ng/mL (P<0.001). When the infants were grouped according to prematurity related complications; transfusion numbers, serum ferritin, and MDA levels of those with two or more complications were significantly higher when compared to cases without complications (P<0.001, P=0.001, and P=0.019, respectively). In conclusion, iron status of VLBW infants has to be monitored to detect iron deficiency and also transfusion-related iron overload. Ferritin can be used to assess the iron status of preterms. Ferritin levels can also reflect lipid peroxidation as we have shown its correlation with MDA, the levels of which were higher in infants with two or more prematurity-related complications. It is important to use restrictive transfusion guidelines in order to protect preterms from iron overload and oxidative stress. Further research is necessary to determine a cut-off level for ferritin to decide when to start iron prophylaxis. B-209 An Evaluation of the HemoCue Assay for the Rapid Assessment of Plasma Free Hemoglobin in Pediatric Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO) F. Gowani, C. Deel, P. Lowery, L. Barton, N. Tran, F. Yin, P. Akl, K. E. Blick. Un of OK Health Sci Ctr, Oklahoma City, OK Background: Extracorporeal membrane oxygenation (ECMO) therapy on newborns is associated wi