title: Monitoring mesenteric tissue oxygenation with near-infrared spectroscopy during packed red blood cell transfusion in preterm infants.
abstract: OBJECTIVE
  To monitor altered mesenteric tissue oxygen saturation (StO2) before and after blood transfusion.
  
  
  METHODS
  We placed a 4-wavelength NIRS sensor (FORE-SIGHT, CASMED, Branford, CT USA) on the right lower abdominal quadrant prior to transfusion and measured StO2 for up to 48 hours post transfusion. Pulse oximetry (SpO2) data was collected simultaneously, with fractional tissue oxygen extraction (FTOE) and the [SpO2-StO2] difference calculated to normalize for hypoxic episodes. All data was combined and averaged in 30 minute windows for events before, during, and post transfusion to determine long term trends and analyzed using Repeated Measures ANOVA. 24 infants were enrolled in this study with 36 hours of data collected for 23 subjects and 48 hours for 16 subjects.
  
  
  RESULTS
  We found no significant differences in any of the parameters when compared pre and post transfusion values at 3, 6, 12, 24 and 36 hours post transfusion. For the 16 subjects monitored to 48 hours, there was a significant decrease in FTOE and near significant increase in StO2 and reciprocal decrease in [SpO2 - StO2] at 48 hours post transfusion.
  
  
  CONCLUSIONS
  There are several plausible mechanisms that may explain the relationship between necrotizing enterocolitis and PRBC transfusion; however, mesenteric tissue oxygen saturation changes did not clearly show that ischemia or re-perfusion injury to be one of the potential mechanisms.
authors.forename: L
authors.initials: L
authors.lastname: White
authors.forename: M
authors.initials: M
authors.lastname: Said
authors.forename: K
authors.initials: K
authors.lastname: Rais-Bahrami
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000704:Analysis of Variance; D020345:Enterocolitis, Necrotizing / Q000209:etiology* / Q000628:therapy; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D008297:Male; D008643:Mesentery / Q000378:metabolism*; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry; D010101:Oxygen Consumption; D019265:Spectroscopy, Near-Infrared
keywords: NEC; NIRS; mesenteric saturation; transfusion