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The effect of blood transfusion on cerebral hemodynamics in preterm infants.
MedLine Citation:
PMID:  23145971     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Anemia of prematurity commonly occurs in infants with very low birth weight; blood transfusion is an important treatment. However, there is no clear evidence to support the criteria currently widely used, based on blood hemoglobin (bHb) and hematocrit indices. Previous studies showed that overtransfusion or a low threshold for transfusion could induce complications or neurologic sequelae, respectively. We hypothesized that a cerebral hemodynamic index may provide an appropriate criterion for determining the need for transfusion in anemic preterm infants. STUDY DESIGN AND METHODS: We used near-infrared time-resolved spectroscopy to measure cerebral hemoglobin oxygen saturation (ScO(2) ) and cerebral blood volume (CBV) before and after transfusion in 19 infants (24 measurements) with anemia of prematurity. The median gestational age was 27 weeks 0 days, median birth weight was 751 g, and median postconceptual age at transfusion was 30 weeks 4 days. RESULTS: bHb levels before and after transfusion (mean ± SD) were 9.3 ± 1.4 and 13.7 ± 1.3 g/dL, respectively. After transfusion, CBV significantly decreased from 2.63 ± 0.60 to 2.13 ± 0.26 mL/100 g of brain, and ScO(2) significantly increased from 72.8 ± 4.3% to 74.7 ± 4.2%. CONCLUSION: After transfusion, CBV changes were significantly greater with low compared to high pretransfusion Hb levels. This reflected the physiologic response to severe anemia in premature infants, which is to increase CBV and decrease ScO(2) . Therefore, CBV and ScO(2) may be useful markers for determining the need for transfusion in very-low-birth-weight infants.
Authors:
Kosuke Koyano; Takashi Kusaka; Shinji Nakamura; Makoto Nakamura; Yukihiko Konishi; Takanori Miki; Masaki Ueno; Saneyuki Yasuda; Hitoshi Okada; Tomoko Nishida; Kenichi Isobe; Susumu Itoh
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-12
Journal Detail:
Title:  Transfusion     Volume:  -     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 American Association of Blood Banks.
Affiliation:
Maternal Perinatal Center, Department of Pediatrics, Department of Anatomy and Neurobiology, Kagawa University, Kitagun, Kagawa, Japan; Departments of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Kitagun, Kagawa, Japan; Department of Education for Children with Special Needs, Faculty of Education, Kagawa University, Takamatsu City, Kagawa, Japan.
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