title: Feeding preterm infants during red blood cell transfusion is associated with a decline in postprandial mesenteric oxygenation.
abstract: OBJECTIVE
  To evaluate the mesenteric tissue oxygenation response in preterm infants fed and not fed during red blood cell (RBC) transfusions.
  
  
  METHODS
  Prospective, observational comparison of mesenteric oxygenation using near-infrared spectroscopy in preterm infants (<33 weeks' at birth) who were fed or not fed during RBC transfusion. Tissue oxygenation means were examined up to 48 hours after each transfusion event.
  
  
  RESULTS
  Mean mesenteric regional oxygen saturation (rSO2) slopes during RBC transfusion of fed (n = 9) vs not fed (n = 8) infants ranged from -0.23 to +0.23 (mean 0.04) with no differences between groups (P = .480). However, following transfusions, postprandial mesenteric oxygenation means significantly declined in infants fed during transfusion compared with infants not fed during transfusion (P < .001). Infants fed during RBC transfusion had a mean 2.16 point decrease in rSO2 mesenteric oxygenation with each sequential feeding post-transfusion, whereas infants not fed during RBC transfusion increased their rSO2 postprandial mesenteric oxygenation by a mean of 2.09 points.
  
  
  CONCLUSIONS
  Mesenteric tissue oxygenation during RBC transfusion is not influenced by feeding status. However, infants fed during RBC transfusion had, for the next 15 hours, decreasing postprandial mesenteric tissue oxygenation patterns compared with infants not fed during RBC transfusion. Feeding during RBC transfusions may increase the risk for mesenteric ischemia and the development of transfusion-related necrotizing enterocolitis in preterm infants.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. Electronic address: tmarin@emory.edu.
authors.forename: Terri
authors.initials: T
authors.lastname: Marin
authors.affiliation: Departments of Pathology and Pediatrics, Emory University School of Medicine, Atlanta, GA; Department of Pathology, Children's Healthcare of Atlanta Blood and Tissue Services, Atlanta, GA.
authors.forename: Cassandra D
authors.initials: CD
authors.lastname: Josephson
authors.affiliation: Division of Neonatology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
authors.forename: Niki
authors.initials: N
authors.lastname: Kosmetatos
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Higgins
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Texas, Southwestern, Dallas, TX.
authors.forename: James E
authors.initials: JE
authors.lastname: Moore
mesh_terms: D004750:Enteral Nutrition; D017707:Erythrocyte Transfusion; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008643:Mesentery / Q000378:metabolism*; D010100:Oxygen / Q000378:metabolism*; D019518:Postprandial Period; D011446:Prospective Studies
chemical_list: D010100:Oxygen