title: Effect of blood transfusion on intestinal blood flow and oxygenation in extremely preterm infants during first week of life.
abstract: BACKGROUND
  Extremely preterm infants receive frequent blood transfusions in the first week of life. The aim of this study was to measure the effect of blood transfusion on intestinal blood flow and oxygenation during the first week of life in extremely preterm infants.
  
  
  METHODS
  Superior mesenteric artery (SMA) peak systolic velocity (PSV) and diastolic velocities were measured 30 to 60 minutes before and after transfusion. Splanchnic tissue hemoglobin index (sTHI), splanchnic tissue oxygenation index (sTOI), and splanchnic fractional tissue oxygen extraction (sFTOE) were measured continuously from 15 to 20 minutes before to after transfusion along with vital variables.
  
  
  RESULTS
  Twenty infants were studied (median gestational age, 26 weeks). Ten infants were partially fed (15-68 mL/kg/day). Heart rate and SaO2 remained unaltered; blood pressure increased significantly (p < 0.01) after transfusion. Mean SMA PSV (p = 0.63) and diastolic velocity (p = 0.65) remained unaltered. Mean pretransfusion SMA PSV was similar in partially fed (0.78 m/sec) compared to unfed infants (0.52 m/sec; p = 0.06) and the response to transfusion was not dissimilar. There was a significant increase in sTHI (mean difference, 32.3%; p < 0.01) and sTOI (14.6%; p = 0.03) and decrease in sFTOE (22.1%; p < 0.01) after transfusion. There was no significant difference in sTHI or sTOI between fed and unfed infants and their response to transfusion.
  
  
  CONCLUSIONS
  Blood transfusion increased blood pressure and intestinal tissue oxygenation but did not alter blood flow velocities. Partial feeding had no impact on intestinal blood flow and tissue oxygenation changes.
authors.affiliation: Neonatal Unit, Homerton University Hospital NHS Foundation Trust.|Centre for Paediatrics, Barts and the London School of Medicine and Dentistry, Queen Mary University of London.|Portland Hospital.
authors.forename: Jayanta
authors.identifier: http://orcid.org/0000-0002-7765-8439
authors.initials: J
authors.lastname: Banerjee
authors.affiliation: Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
authors.forename: Terence S
authors.initials: TS
authors.lastname: Leung
authors.affiliation: Neonatal Unit, Homerton University Hospital NHS Foundation Trust.|Centre for Paediatrics, Barts and the London School of Medicine and Dentistry, Queen Mary University of London.|Department of Paediatrics, SDM Medical College and Hospitals, Dharwad, India.
authors.forename: Narendra
authors.initials: N
authors.lastname: Aladangady
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure; D001803:Blood Transfusion; D005260:Female; D005865:Gestational Age; D006339:Heart Rate; D006801:Humans; D062071:Infant, Extremely Premature / Q000502:physiology; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D007413:Intestinal Mucosa / Q000378:metabolism*; D007422:Intestines / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D010101:Oxygen Consumption; D012039:Regional Blood Flow / Q000502:physiology*; D013152:Splanchnic Circulation / Q000502:physiology*; D014463:Ultrasonography