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Early red cell transfusion favourably alters cerebral oxygen extraction in very preterm newborns

C C Andersen1, S M Karayil2, N A Hodyl1

  • 1Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|April 17, 2015
PubMed

Insights

Early red blood cell (RBC) transfusion in preterm infants with high cerebral fractional tissue oxygen extraction (cFTOE) improved cerebral oxygen kinetics. This intervention may help reduce the risk of hypoxic brain injury.

Area of Science:

  • Neonatal physiology
  • Cerebral oxygenation monitoring
  • Red blood cell transfusion effects

Background:

  • Elevated cerebral fractional tissue oxygen extraction (cFTOE; ≥0.4) is a predictor of early brain injury in very preterm infants.
  • The impact of immediate newborn red blood cell (RBC) transfusion on cerebral oxygen kinetics is not well understood.

Purpose of the Study:

  • To determine the effect of RBC transfusion within 24 hours of birth on cFTOE in infants born at or before 29 weeks gestation.

Main Methods:

  • Cerebral fractional tissue oxygen extraction (cFTOE) was measured using cerebral tissue oxygenation index (TOI) and cutaneous oximetry.
  • Measurements were taken over a 30-minute period before and after transfusion.
  • Infants were categorized into low (<0.4) and high (≥0.4) pre-transfusion cFTOE groups.

Main Results:

  • Twenty-four infants were analyzed, with 12 in each group.
  • Hemoglobin levels were comparable between groups before and after transfusion.
  • A significant reduction in cFTOE was observed post-transfusion in the high-extraction group (p<0.01), but not in the low-extraction group.

Conclusions:

  • Early RBC transfusion positively influences cerebral oxygen kinetics in preterm infants with elevated cFTOE.
  • This suggests a potential role for early transfusion in mitigating the risk of hypoxic brain injury.
Abstract

Keywords:
Injury PreventionNeonatologyPhysiology

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