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Updated: Mar 16, 2026

Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Blood transfusion in preterm infants improves intestinal tissue oxygenation without alteration in blood flow
J Banerjee1,2,3, T S Leung4, N Aladangady1,2,5
1Neonatal Unit, Homerton University Hospital NHS Foundation Trust, London, UK.
Insights
Blood transfusions improve intestinal oxygenation in preterm infants by increasing splanchnic tissue oxygenation index (sTOI) and hemoglobin index (sTHI), without altering superior mesenteric artery (SMA) blood flow velocity.
Area of Science:
- Neonatal Physiology
- Pediatric Gastroenterology
- Medical Imaging
Background:
- Preterm infants often require blood transfusions.
- Assessing the impact of transfusions on splanchnic circulation is crucial for preterm infant care.
- Postnatal age may influence the response to transfusion.
Purpose of the Study:
- To investigate splanchnic blood flow velocity and oximetry in preterm infants undergoing blood transfusion.
- To analyze these responses in relation to the infant's postnatal age.
Main Methods:
- Doppler ultrasound measured superior mesenteric artery (SMA) peak systolic velocity (PSV).
- Near-infrared spectroscopy assessed splanchnic tissue hemoglobin index (sTHI), oxygenation index (sTOI), and fractional tissue oxygen extraction (sFTOE).
- Infants were grouped by postnatal age: 1-7 days, 8-28 days, and ≥29 days.
Main Results:
- Pretransfusion SMA PSV varied with postnatal age but did not significantly change post-transfusion.
- Splanchnic tissue hemoglobin index (sTHI) and oxygenation index (sTOI) increased significantly post-transfusion in all groups (P < 0.01).
- Fractional tissue oxygen extraction (sFTOE) decreased significantly post-transfusion (P < 0.01).
Conclusions:
- Preterm infants' baseline splanchnic oximetry and blood flow differ based on postnatal age.
- Blood transfusion effectively enhances intestinal tissue oxygenation.
- Mesenteric blood flow velocity remains unchanged post-transfusion, regardless of postnatal age.
Background And Objective:
The objective of the study was to investigate the splanchnic blood flow velocity and oximetry response to blood transfusion in preterm infants according to postnatal age.
Materials And Methods:
Preterm infants receiving blood transfusion were recruited to three groups: 1-7 (group 1; n = 20), 8-28 (group 2; n = 21) and ≥29 days of life (group 3; n = 18). Superior mesenteric artery (SMA) peak systolic (PSV) and diastolic velocities were measured 30-60 min pre- and post-transfusion using Doppler ultrasound scan. Splanchnic tissue haemoglobin index (sTHI), tissue oxygenation index (sTOI) and fractional tissue oxygen extraction (sFTOE) were measured from 15-20 min before to post-transfusion using near-infrared spectroscopy.
Results:
The mean pretransfusion Hb in group 1, 2 and 3 was 11, 10 and 9 g/dl, respectively. The mean (SD) pretransfusion SMA PSV in group 1, 2 and 3 was 0·63 (0·32), 0·81 (0·33) and 0·97 (0·40) m/s, respectively, and this did not change significantly following transfusion. The mean (SD) pretransfusion sTOI in group 1, 2 and 3 was 36·7 (19·3), 44·6 (10·4) and 41·3 (10·4)%, respectively. The sTHI and sTOI increased (P < 0·01), and sFTOE decreased (P < 0·01) following transfusion in all groups. On multivariate analysis, changes in SMA PSV and sTOI following blood transfusion were not associated with PDA, feeding, pretransfusion Hb and mean blood pressure.
Conclusion:
Pretransfusion baseline splanchnic tissue oximetry and blood flow velocity varied with postnatal age. Blood transfusion improved intestinal tissue oxygenation without altering mesenteric blood flow velocity irrespective of postnatal ages.
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