Related Experiment Video
Updated: Jun 19, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Impact of feeding strategies during red blood cell transfusion on cerebral and splanchnic oxygenation in preterm
Sevgi Aslan Tuncay1, Hulya Ozdemir2, Abdullah Sarioz3,4
1Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University Faculty of Medicine, Istanbul, Turkey.
Insights
This pilot study found no significant differences in infant oxygenation with different feeding strategies during red blood cell (RBC) transfusions. Further research is needed to confirm these findings for transfusion-related necrotizing enterocolitis (TR-NEC) prevention.
Area of Science:
- Neonatalogy
- Pediatric Gastroenterology
- Critical Care Medicine
Background:
- Red blood cell (RBC) transfusion is linked to transfusion-related necrotizing enterocolitis (TR-NEC) in preterm infants.
- Peri-transfusion feeding practices vary, potentially influencing outcomes.
Purpose of the Study:
- To investigate the effect of three feeding strategies on cerebral and splanchnic oxygenation during RBC transfusion in very preterm infants.
- To explore the relationship between feeding strategies, oxygenation, and TR-NEC incidence.
Main Methods:
- A single-center randomized pilot trial involving infants <32 weeks' gestation requiring RBC transfusion.
- Infants were assigned to feeds withheld, reduced by 50%, or continued during transfusion.
- Near-infrared spectroscopy (NIRS) measured cerebral and splanchnic oxygenation (rSO2, FTOE, SCOR) pre-, during, and post-transfusion.
Main Results:
- No statistically significant differences in cerebral or splanchnic oxygenation (rSO2, FTOE, SCOR) were observed between the three feeding groups.
- Exploratory analysis indicated lower pre- and during-transfusion splanchnic oxygenation in infants who developed TR-NEC.
- TR-NEC occurred in 8/45 infants (2, 1, and 5 across groups).
Conclusions:
- This pilot study did not demonstrate significant differences in cerebral or splanchnic oxygenation based on feeding strategies during RBC transfusion.
- Findings are hypothesis-generating and do not imply equivalence; larger trials are required for confirmation.
- Further investigation is needed to optimize feeding practices and reduce TR-NEC risk in transfused preterm infants.
Abstract:
BackgroundRed blood cell (RBC) transfusion in very preterm infants has been linked to transfusion-related necrotizing enterocolitis (TR-NEC), and peri-transfusion feeding practices vary. We examined whether three different feeding strategies affect cerebral and splanchnic oxygenation.MethodsIn this single-center randomized pilot trial, infants <32 weeks' gestation requiring RBC transfusion were allocated to feeds withheld, feeds reduced by 50%, or feeds continued during transfusion. Near-infrared spectroscopy measured cerebral and splanchnic rSO2 from 2 h before transfusion start through 42 h after completion (covering the remainder of the 48-h post-initiation window used to define TR-NEC). FTOE and SCOR were calculated. Prespecified primary endpoints were between-group differences in changes in CrSO2, SrSO2, and corresponding FTOE across pre-specified epochs; secondary endpoints were feeding intolerance and TR-NEC (Bell stage ≥II within 48 h).ResultsForty-five infants were enrolled (14, 14, and 17 per group). Splanchnic rSO2 increased and splanchnic FTOE decreased during and after transfusion; cerebral rSO2 increased after transfusion with decreased cerebral FTOE. No statistically significant differences in, FTOE, or SCOR were detected between feeding groups. TR-NEC occurred in eight infants (2, 1, and 5 per group). In exploratory analyses, infants who developed TR-NEC had lower splanchnic rSO2 and higher splanchnic FTOE before and during transfusion.ConclusionsNo statistically significant differences were demonstrated in cerebral or splanchnic oxygenation among three feeding strategies during RBC transfusion. As a pilot, hypothesis-generating study, these findings should not be interpreted as equivalence between strategies and require confirmation in larger trials.
