Document Detail


Blood transfusions increase cerebral, splanchnic, and renal oxygenation in anemic preterm infants.
MedLine Citation:
PMID:  20113454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multiprobe near infrared spectroscopy (NIRS) has been used to study regional cerebral (rSO(2)C), splanchnic (rSO(2)S), and renal (rSO(2)R) tissue oxygenation in newborns. We used this method to study the effects of red blood cell (RBC) transfusions in anemic preterm infants to assess if thresholds for transfusions were appropriate for recognizing a clinical condition permitting tissue oxygenation improvement. STUDY DESIGN AND METHODS: Multiprobe NIRS (INVOS 5100, Somanetics) was applied during transfusion to 15 preterm infants with symptomatic anemia of prematurity (hematocrit level of <25%). rSO(2)C, rSO(2)S, and rSO(2)R were recorded at selected times, and then fractional oxygen cerebral extraction ratio [FOEC: (SaO(2)-rSO(2)C)/SaO(2)], fractional oxygen splanchnic extraction ratio [FOES: (SaO(2)-rSO(2)S)/SaO(2)], fractional oxygen renal extraction ratio [FOER: (SaO(2)-rSO(2)R)/SaO(2)], cerebrosplanchnic oxygenation ratio [CSOR: (rSO(2)S/rSO(2)C)], and cerebrorenal oxygenation ratio [CROR: (rSO(2)R/rSO(2)C)] were calculated. In addition, we used Doppler ultrasonography for evaluating cerebral blood flow (CBF), splanchnic blood flow (SBF), and renal blood flow (RBF) velocity. RESULTS: rSO(2)C, rSO(2)S, and rSO(2)R significantly increased during transfusions, while FOEC, FOES, and FOER decreased. CSOR and CROR increased during transfusions. CBF velocity decreased during the study period, while SBF and RBF velocities did not vary. CONCLUSION: RBC transfusions performed at used thresholds permitted an increase in cerebral, splanchnic, and renal oxygenation. The associated decreases in oxygen tissue extraction might suggest that transfusions were well timed for preventing tissue hypoxia or too early and theoretically prooxidant. Further studies could help to clarify this issue.
Authors:
Carlo Dani; Simone Pratesi; Giulia Fontanelli; Jacopo Barp; Giovanna Bertini
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Publication Detail:
Type:  Journal Article     Date:  2010-01-22
Journal Detail:
Title:  Transfusion     Volume:  50     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-07-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1220-6     Citation Subset:  IM    
Affiliation:
Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy. cdani@unifi.it
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MeSH Terms
Descriptor/Qualifier:
Anemia, Neonatal / metabolism*,  therapy*
Cerebellum / metabolism*
Erythrocyte Transfusion*
Female
Humans
Infant, Newborn
Infant, Premature / metabolism*
Kidney / metabolism*
Male
Oxygen Consumption*
Spectroscopy, Near-Infrared
Comments/Corrections
Comment In:
Transfusion. 2010 Jun;50(6):1170-2   [PMID:  20598099 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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