title: Packed red blood cell transfusion (PRBC) attenuates intestinal blood flow responses to feedings in pre-term neonates with normalization at 24 hours.
abstract: OBJECTIVE
  To determine whether packed red blood cell (PRBC) transfusion affects post-prandial superior mesenteric artery blood flow velocities (SMA BFVs) in very-low birth weight (VLBW) neonates and if so, at what time point after transfusion restoration of previous SMA BFV patterns occurs.
  
  
  METHODS
  VLBW pre-term neonates, older than 14 days and tolerating bolus enteral feedings administered every 3 h were enrolled in this prospective observational study. Pulsed Doppler ultrasound was used to measure pre- and post-prandial (at 45 min) time-averaged mean, peak and end diastolic velocities (TAMV, PSV, EDV) immediately before and after 15 ml/kg of PRBC transfusion was given over 3 h; patent ductus arteriosus (PDA) status was also evaluated. Subsequent pre- and post-prandial SMA BFVs were recorded 24 and 48 h after the transfusion.
  
  
  RESULTS
  Pre- and post-prandial measurements were obtained for 21 out of 25 enrolled infants. Post-prandial SMA BFVs were attenuated during the feedings immediately after transfusion; at 24 and 48 h after transfusion, changes in post-prandial SMA BFVs were similar to those measured prior to transfusion; the presence of the PDA did not affect results.
  
  
  CONCLUSIONS
  PRBC transfusion blunted SMA BFV responses to feedings immediately after the transfusion with normalization observed 24 h post-transfusion.
authors.affiliation: a Department of Pediatrics .
authors.forename: Aaron
authors.initials: A
authors.lastname: Pitzele
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rahimi
authors.forename: Eric
authors.initials: E
authors.lastname: Armbrecht
authors.forename: Thomas
authors.initials: T
authors.lastname: Havranek
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology; D004374:Ductus Arteriosus, Patent / Q000503:physiopathology; D015150:Echocardiography, Doppler; D004750:Enteral Nutrition / Q000009:adverse effects; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006400:Hematocrit; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000503:physiopathology; D019102:Infant, Very Low Birth Weight; D008297:Male; D017538:Mesenteric Artery, Superior / Q000502:physiology*; D019518:Postprandial Period; D013997:Time Factors
keywords: Doppler ultrasound; intestinal blood flow; packed red blood cell transfusion; preterm neonate