title: Changes in regional tissue oxygenation saturation and desaturations after red blood cell transfusion in preterm infants.
abstract: OBJECTIVE
  The study investigated the ability of near-infrared spectroscopy (NIRS) to detect subgroups of preterm infants who benefit most from red blood cell (RBC) transfusion in regard to cerebral/renal tissue oxygenation (i) and the number of general oxygen desaturation below 80% (SaO(2) <80%) (ii).
  
  
  METHODS
  Cerebral regional (crSO(2)) and peripheral regional (prSO(2)) NIRS parameters were recorded before, during, immediately after and 24 h after transfusion in 76 infants. Simultaneously, SaO(2) <80% were recorded by pulse oximetry. To answer the basic question of the study, all preterm infants were divided into two subgroups according to their pretransfusion crSO(2) values (<55% and ≥55%). This cutoff was determined by a k-means clustering analysis.
  
  
  RESULTS
  crSO(2) and prSO(2) increased significantly in the whole study population. A stronger increase (P<0.0005) of both was found in the subgroup with pretransfusion crSO(2) values <55%. Regarding the whole population, a significant decrease (P<0.05) of episodes with SaO(2) <80% was observed. The subgroup with crSO(2) baselines <55% had significant (P<0.05) more episodes with SaO(2) <80% before transfusion. During and after transfusion, the frequency of episodes with SaO(2) <80% decreased more in this group compared with the group with crSO(2) baselines ≥55%.
  
  
  CONCLUSIONS
  NIRS measurement is a simple, non-invasive method to monitor regional tissue oxygenation and the efficacy of RBC transfusion. Infants with low initial NIRS values benefited most from blood transfusions regarding SaO(2) <80%, which may be important for their general outcome.
authors.affiliation: Division of Neonatology, University of Leipzig, Children's Hospital, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Seidel
authors.forename: A
authors.initials: A
authors.lastname: Bläser
authors.forename: C
authors.initials: C
authors.lastname: Gebauer
authors.forename: F
authors.initials: F
authors.lastname: Pulzer
authors.forename: U
authors.initials: U
authors.lastname: Thome
authors.forename: M
authors.initials: M
authors.lastname: Knüpfer
mesh_terms: D000751:Anemia, Neonatal / Q000378:metabolism / Q000628:therapy; D001921:Brain / Q000378:metabolism*; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007668:Kidney / Q000378:metabolism*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D010100:Oxygen