title: Assessment of red blood cell transfusion and transfusion duration on cerebral and mesenteric oxygenation using near-infrared spectroscopy in preterm infants with symptomatic anemia.
abstract: BACKGROUND
  The aim of red blood cell (RBC) transfusion is to improve tissue oxygenation and relieve anemia-related symptoms in preterm infants. We sought to assess regional cerebral (rSO2 C) and mesenteric (rSO2 M) tissue oxygenation using a near-infrared spectroscopy (NIRS) method and vital signs (heart rate, arterial oxygen saturation, mean arterial blood pressure) in symptomatic preterm infants with anemia who received RBC transfusions.
  
  
  METHODS
  Twenty-three symptomatic patients with anemia who were at least 1 month old, whose gestational age was less than 30 weeks, and whose hematocrit level was not more than 27% were involved in the transfusion group. The control group consisted of preterm infants (Hct ≥ 32) matched for gestational age and postnatal days. The transfusion group was divided into two subgroups based on transfusion duration (2 or 4 hr). Both study groups were monitored for vital signs and rSO2 C, rSO2 M, and mesenteric-cerebral oxygenation ratio (MCOR) via NIRS for 24 hours simultaneously and compared with the control group. NIRS variables and vital signs obtained before, during, and after transfusion were compared both within and between 2- and 4-hour groups.
  
  
  RESULTS
  rSO2 C, rSO2 S, and MCOR increased during and after transfusions, while cerebral fractional oxygen extraction (FOEC) and mesenteric fractional oxygen extraction (FOEM) decreased. No significant difference was found between subgroups for NIRS measurements and vital signs. A weak correlation between hemoglobin concentration and FOEC and FOEM was found.
  
  
  CONCLUSIONS
  RBC transfusion improved cerebral-mesenteric oxygenation and MCOR in symptomatic infants with anemia, independent of the transfusion duration.
authors.affiliation: Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
authors.forename: Gonca
authors.initials: G
authors.lastname: Sandal
authors.forename: Serife S
authors.initials: SS
authors.lastname: Oguz
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Melek
authors.initials: M
authors.lastname: Akar
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000751:Anemia, Neonatal / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D002540:Cerebral Cortex / Q000378:metabolism*; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism; D008297:Male; D008643:Mesentery / Q000378:metabolism*; D010101:Oxygen Consumption / Q000502:physiology*; D010865:Pilot Projects; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors