title: Early red cell transfusion favourably alters cerebral oxygen extraction in very preterm newborns.
abstract: BACKGROUND
  Elevated cerebral fractional tissue oxygen extraction (cFTOE; ≥0.4) predicts early brain injury in very preterm infants. While blood transfusion increases oxygen-carrying capacity, its ability to improve cerebral oxygen kinetics in the immediate newborn period remains unknown.
  
  
  OBJECTIVE
  To investigate the effect of red blood cell (RBC) transfusion in the first 24 h of life on cFTOE in infants ≤29 weeks gestation.
  
  
  METHODS
  cFTOE was calculated from cerebral tissue oxygenation index (TOI) and cutaneous oximetry measured over a 30 min epoch before and after transfusion. Infants were dichotomised according to pre-transfusion cFTOE (low <0.4 vs high ≥0.4).
  
  
  RESULTS
  24 babies were included, 12 in each group. Pre- and post-transfusion Hb were similar between the groups. cFTOE significantly reduced after transfusion in the high but not low-extraction group (p<0.01).
  
  
  CONCLUSIONS
  Early RBC transfusion favourably alters cerebral oxygen kinetics in infants with elevated cFTOE, showing potential for modification of the risk of hypoxic (brain) injury.
authors: Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.
authors: C C
authors: CC
authors: Andersen
authors: Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia.
authors: S M
authors: SM
authors: Karayil
authors: Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.
authors: N A
authors: NA
authors: Hodyl
authors: Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.
authors: M J
authors: MJ
authors: Stark
mesh_terms: D001921:Brain / Q000378:metabolism*; D002560:Cerebrovascular Circulation; D017707:Erythrocyte Transfusion; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D002534:Hypoxia, Brain / Q000517:prevention & control; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000517:prevention & control; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared
chemical_list: D006454:Hemoglobins; D010100:Oxygen
keywords: Injury Prevention; Neonatology; Physiology