Packed Red Blood Cell Transfusion Increases Regional Cerebral and Splanchnic Tissue Oxygen Saturation in Anemic Symptomatic Preterm Infants

ABSTRACT

Preterm infants often receive multiple packed red blood cell (PRBC) transfusions that are intended to improve tissue oxygen levels. Near-infrared spectroscopy (NIRS) monitors regional cerebral tissue oxygen saturation (CrSO₂) and splanchnic tissue oxygen saturation (SrSO₂). Before such technology can be employed in neonatal transfusion management, it must first be established that transfusions result in an increase in tissue oxygen saturation. This prospective, observational study used NIRS to determine if PRBC transfusions increase the CrSO₂ and SrSO₂ of symptomatic anemic premature neonates. CrSO₂ and SrSO₂ values were compared for 20-minute duration immediately before, during, immediately after, and 12 hours after transfusion. As a secondary objective, CrSO₂ and SrSO₂ values were correlated with hemoglobin (Hgb) levels. One-way analysis of variance and Pearson correlation statistical tests were used for analysis. A statistically significant increase in CrSO₂ and SrSO₂ values were observed after transfusion in the 30 subjects included (CrSO₂: 62.8 ± 1.6, 65.6 ± 1.7, 68.0 ± 1.3, 67.6 ± 1.4, p < 0.001 and SrSO₂: 41.3 ± 2.2, 46.7 ± 3.0, 52.1 ± 2.8, 48.2 ± 2.5, p < 0.001). No correlation was found between CrSO₂ or SrSO₂ and Hgb values. NIRS identified increases in CrSO₂ and SrSO₂ in preterm neonates after PRBC transfusions and has the potential to become incorporated into neonatal transfusion management paradigms.

KEYWORDS

Premature neonates - near-infrared spectroscopy - blood transfusion - cerebral tissue oxygen saturation - splanchnic tissue oxygen saturation

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