Journal
JOURNAL OF PERINATOLOGY
Volume 38, Issue 12, Pages 1636-1643Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/s41372-018-0229-1
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Funding
- Vanderbilt Institute for Clinical and Translational Research
- Department of Pediatrics at Vanderbilt University Medical Center
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Objective To test the hypothesis that cerebral oxygen extraction fraction (OEF) is elevated and inversely related to hematocrit level in anemic former very-low-birth-weight infants near term. Study design Prospective study of non-sedated preterm infants (post-menstrual age = 36 +/- 2 weeks) over a range of hematocrits (0.23-0.49). Anatomical (T-1-W, T-2-W, and diffusion-weighted), cerebral blood flow (CBF), and OEF 3-T MRI were utilized. Statistical analysis included Spearman's rank-order correlation testing between study variables and intraclass correlation coefficients (ICC) calculated between consecutively acquired OEF scans. Results Consecutive OEF measurements showed moderate-to-good agreement (ICC = 0.71; 95% CI = 0.40-0.87). OEF increased with worsening anemia (rho = -0.58; p = 0.005), and OEF and basal ganglia CBF were positively correlated (rho = 0.49; p = 0.023). Conclusion Noninvasive OEF MRI has moderate-to-good repeatability in non-sedated former preterm infants nearing term-equivalent age. Strong correlation of elevated OEF with anemia suggests hemodynamic compensation for anemia and could establish OEF as a useful biomarker of transfusion threshold for preterm infants.
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