Impact of Enteral Feeding on Cerebral and Splanchnic Oxygenation During Packed Red Blood Cell Transfusion in Preterm...

To investigate the impact of enteral feeding during packed red blood cell transfusion (PRBCT) on splanchnic and cerebral regional oxygenation (sRSO2, cRSO2) in very-low-birthweight (VLBW) neonates.

Randomised controlled study. Place and Duration of the Study: Department of Neonatology, Faculty of Medicine, Akdeniz University, Antalya, Turkiye, from June 2021 to June 2024.

Fifty-six VLBW neonates were categorised into No-feeding and Feeding groups. sRSO2, cRSO2, the ratio of sRSO2 to cRSO2 (SCOR), splanchnic and cerebral fractionated tissue oxygen extraction (sFTOE, cFTOE) were measured at predetermined intervals using near-infrared spectroscopy. Bonferroni-corrected linear mixed models were used to assess repeatedly measured variables across different time points.

An overall increase in sRSO2 and cRSO2 was observed during the study. In contrast to a steady sRSO2 incline in the No-feeding group, the Feeding group exhibited a temporary reduction in sRSO2 and SCOR, followed by an increase in sFTOE during the first hour of PRBCT (∆Mean = -1.958, ∆Mean = -0.024, ∆Mean = 2.088, respectively). Despite the changing patterns in splanchnic oxygenation, the mean differences in sRSO2 and sFTOE between the two groups were -0.67 (95% CI: -2.74 - 1.40, p = 0.520) and 0.83 (95% CI: -1.46 -3.12, p = 0.473), indicating the impact of enteral feeding on sRSO2 was insignificant.

The findings demonstrated improved outcomes in both cerebral and splanchnic oxygenation during PRBCT in stable preterm infants, despite a temporary impairment in splanchnic tissue oxygen utilisation in the Feeding group. Enteral feeding alone did not pose a risk for transfusion-associated necrotising enterocolitis (TANEC). Large-scale studies are warranted to clarify the complex interplay between enteral feeding, transfusion, and tissue oxygenation.

Blood transfusion, Enteral feeding, Preterm infants, Very-low-birthweight infants, Splanchnic regional oxygenation, Cerebral regional oxygenation, Transfusion-associated necrotising enterocolitis.