Journal
AMERICAN JOURNAL OF PERINATOLOGY
Volume 35, Issue 11, Pages 1031-1037Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0038-1636532
Keywords
red blood cell transfusion; intestinal regional tissue oxygen saturation; cerebral regional tissue oxygen saturation; necrotizing enterocolitis; preterm infants; variability; hemoglobin; near-infrared spectroscopy
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Funding
- University of Groningen
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Objective To assess intestinal and cerebral oxygenation during and after red blood cell (RBC) transfusions in preterms with or without subsequent transfusion-associated necrotizing enterocolitis (TANEC). Study Design In preterms of<32 weeks' gestational age, we measured intestinal and cerebral regional tissue oxygen saturation (r (int) SO (2) , r (c) SO (2) ) and their variabilities using near-infrared spectroscopy during and after transfusions. We compared eight infants who developed TANEC 6 to 48 hours after RBC transfusions with 16 controls. Results In TANEC infants, r (c) SO (2) was lower during and after RBC transfusions than in controls, median (interquartile range) 55% (50-62) versus 72% (65-75), p <0.01. There were no differences regarding r (int) SO (2) . Individual r (int) SO (2) and r (c) SO (2) ranges were smaller after transfusions in TANEC infants, 28% (9-36) versus 49% (40-65), p <0.01, and 17% (14-33) versus 36% (26-57), p =0.01, as was short-term r (int) SO (2) variability. For each 10% higher r (c) SO (2) , the risk of developing TANEC decreased (odds ratio 0.09; 95% confidence interval 0.01-0.63). The smaller the r (int) SO (2) range after transfusion, the higher the risk of developing TANEC. Conclusion In preterm infants lower r (c) SO (2) , but not r (int) SO (2) , values during and after RBC transfusions are associated with TANEC. Lower r (int) SO (2) and r (c) SO (2) variabilities after RBC transfusions may represent a diminished capacity for vascular adaptation, possibly leading to TANEC.
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