title: The effect of red blood cell transfusion on intermittent hypoxemia in ELBW infants.
abstract: OBJECTIVE
  To test the hypothesis that the effect of red blood cell (RBC) transfusion on intermittent hypoxemia (IH) in extremely low birth weight (ELBW) infants is dependent on postnatal age.
  
  
  METHODS
  Oxygen saturation of 130 ELBW infants, who required transfusion, was monitored continuously for the first 8 weeks of life. We compared the characteristics of IH (SpO2⩽80% for ⩾4 s and ⩽3 min), 24 h before and both 24 h and 24 to 48 h after each RBC transfusion at three distinct time periods: Epoch 1, 1 to 7 days; Epoch 2, 8 to 28 days; and Epoch 3, >28 days.
  
  
  RESULTS
  In Epoch 1, the frequency and severity of IH events were not significantly different before and after transfusion. In both Epochs 2 and 3 there was a decrease in IH frequency and severity 24 h after RBC transfusion that persisted for 48 h. In addition, there was a decrease in the overall time spent with SpO2 ⩽80% which persisted for 24 h after transfusion in Epochs 1 and 3, and for 48 h in Epoch 3.
  
  
  CONCLUSIONS
  The benefit of RBC transfusion on IH is age dependent as improvement in the frequency and severity of IH after transfusion only occurs beyond the first week of life. These observations will aid clinician's decision making by clarifying the benefit of RBC transfusions on patterns of oxygenation in preterm infants.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: E G
authors.initials: EG
authors.lastname: Abu Jawdeh
authors.affiliation: Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Martin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Dick
authors.affiliation: Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Walsh
authors.affiliation: Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Di Fiore
mesh_terms: D017707:Erythrocyte Transfusion; D005260:Female; D006400:Hematocrit; D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D008297:Male