Does red blood cell transfusion change the near infra red photoplethysmography signal in infants?

Seidl, Tamara; Genzel‐Boroviczény, Orsolya; Abicht, Jan‐Michael; Christ, F.

doi:10.1007/s00134-004-2309-2

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…and Table , showing low significance for the dependence of ΔSBF on ΔHct (α=12.5; r = .519; P = .039). This conforms to a previous report, demonstrating that the transfusion‐induced increase in Hct, routinely measured in samples from large blood vessels, is not expressed in the microvascular Hct …”

Section: Resultssupporting

confidence: 93%

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Deformability of transfused red blood cells is a potent determinant of transfusion‐induced change in recipient's blood flow

et al. 2016

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This study provides, for the first time in humans, direct evidence that the deformability of transfused PRBC is a potent effector of transfusion outcome. Currently, PRBC are supplied primarily by the first-in-first-out criteria, while their functionality is ignored. The testing of PRBC hemodynamic quality would introduce a new paradigm into blood banking, which would contribute substantially to improving transfusion therapy.

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Section: Resultssupporting

confidence: 93%

“…This conforms to a previous report, demonstrating that the transfusion-induced increase in Hct, routinely measured in samples from large blood vessels, is not expressed in the microvascular Hct. 8,12,[37][38][39]…”

Section: Effect Of Prbc Deformability On the Transfusion-induced Chmentioning

confidence: 99%

Deformability of transfused red blood cells is a potent determinant of transfusion‐induced change in recipient's blood flow

et al. 2016

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“…Adaptive processes are very different in these situations, in particular concerning transfusion where adult RBC of various age are infused. Using a different technology near-infrared photoplethysmography (NIRP) we have previously shown, that elective transfusions do not change the blood flow in arteriovenous anastomoses as the nonnutrient, high volume, low resistance pathway (26). These vessels are the main source for the NIRP signal.…”

Section: Discussionmentioning

confidence: 99%

Functional Vessel Density in the First Month of Life in Preterm Neonates

Kroth¹,

Weidlich

Hiedl³

et al. 2008

Pediatr Res

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Changes in microcirculation have been recognized as central to many disease processes. The aim of this study was to evaluate factors, which influence the microcirculation of the skin during the first month of life in premature infants. Red blood cell (RBC) velocity, vessel diameter, and functional small vessel density (FSVD) were measured daily for the first 30 d on the upper arm in preterm infants with gestational age Ͻ30 wk. Orthogonal polarization spectral (OPS) images were analyzed off-line with the CapiScope-Image program. In 25 infants, FSVD decreased significantly from week 1 (mean Ϯ SD 236 Ϯ 33 cm/cm 2 ) to week 4 (207 Ϯ 30 cm/cm 2 ) and correlated directly with Hb levels and incubator temperature. Vessel diameters and RBC velocity did not change significantly, nor did clinical parameters such as blood pressure, heart rate or body temperature. Microvascular parameters were not dependent on gestational or postnatal age. The microcirculation of the skin might be an easily accessible window to obtain better understanding of circulatory changes in the postnatal period. Our data are essential as basis for further studies in this field. Hb levels and possible incubator temperatures have a substantial influence on functional small vessel density and therefore need to be taken in account. D isturbances of the microcirculation play a key role in many disease states (1-4). The recent development of new technologies has helped to investigate these changes in adult patients with sepsis (5-7). Previous studies have shown that parameters of microcirculation such as microvessel diameter, red blood cell velocity, and functional small vessel density (FSVD) can be measured in the skin of term and preterm infants by Orthogonal Polarization Spectral (OPS) imaging in the first week of life (8) and that FSVD increases after elective blood transfusion in anemic neonates (9). The microcirculation of the skin plays an important role in maintaining a constant body temperature and in regulating the fluid balance (10,11). Adequate function of the microcirculation is a prerequisite for tissue nutrition and oxygen supply (12). The microcirculation of the skin in neonates differs in several aspects from that of an adult. The regular architecture has been found to be poorly developed in the newborn (13). At birth, the skin shows a disorderly capillary network and no papillary loops in almost all areas, except the palms, soles, and nail folds. The skin is richly supplied by a dense subepidermal plexus demonstrating relatively little regional variation (14).Functional capillary density (FCD) is one of the parameters that delineate the microcirculation. FCD is defined as the length of red cell-perfused capillaries per observation area and is given as cm/cm 2 . FCD has been used as an indicator of the quality of tissue perfusion (15). In neonates capillary vessels, arterioles, and venules cannot clearly be differentiated in the OPS images, so that the expression FSVD is used.The aim of the study was to determine whether tissue pe...

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“…Group size was calculated from AUC or FLUX values based on previous studies (16) and might have been too small to detect changes in these clinical variables.…”

Section: Discussionmentioning

confidence: 99%

“…Microcirculatory parameters were determined with a combined red and near-infrared emission and detection system that has been described previously in detail (7,16). In brief, the volume pulse signal is obtained using a red and near-infrared light source emitting 840 nm and 640 nm light with a sample rate of 128 Hz.…”

Section: Patientsmentioning

confidence: 99%

Impaired Microvascular Perfusion Improves With Increased Incubator Temperature in Preterm Infants

et al. 2007

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ABSTRACT:The optimal thermal environment for sick preterm infants is unknown. Incubator temperature can be regulated to an abdominal wall temperature of 36.5°C [neutral temperature (NT)] or to a minimal temperature difference (Ͻ2°C) between abdominal wall and extremities [comfort temperature (CT)]. This could affect the microcirculation, particularly in infants with impaired perfusion. We assessed the microvascular perfusion with near-infrared photoplethysmography (NIRP) at these two target temperatures between d 1 and 4 of life in preterm infants with normal (NL group) or impaired (RED group) microcirculation as determined by a clinical score. Signal strength variables such as area under the curve (AUC) and the first derivate of the amplitude (FLUX) were calculated. Starting temperature was randomized to NT or to CT and then followed by the other temperature. A significant increase of FLUX and AUC in the RED group was found with NT as starting temperature (FLUX: 282 Ϯ 76 at NT versus 627 Ϯ 211 at CT; p ϭ 0.025; AUC: 73 Ϯ 47 at NT versus 234 Ϯ 112 at CT; p ϭ 0.009), but not with CT. In NL infants, both parameters did not change significantly. Increasing the incubator temperature to CT changes thermoregulatory flow to the extremities in preterm infants with impaired microvascular perfusion and might improve tissue flow. T he optimal thermal environment for nursing sick preterm infants is not known. Neutral thermal zone is traditionally defined as a range of environmental temperatures within which the metabolic rate is minimal and thermoregulation is achieved by nonevaporative means (1,2). NT corresponds to a body surface temperature of about 37°C above the liver, in accordance with a core temperature of approximately 36.5°C regardless of the temperature of the extremities (3,4). CT is defined as a minimal temperature difference between the abdominal wall and the extremities (Ͻ2°C) (3). CT corresponds to an approximate core temperature of 37°C and higher and is close to an intrauterine temperature of 38°C (2,4).Changes in body temperature of about 1°C are primarily associated with changes in total peripheral skin blood flow (5). In term infants with NL exposed to phototherapy an increase of 224% in skin blood flow has been observed using electrocapacitance plethysmography (6). The effect of incubator temperature on circulation and microcirculation of preterm infants with signs of an impaired peripheral microcirculation (e.g. mottled skin) has not yet been reported. In the present study, we compared the effect of different incubator temperatures (NT and CT) on indices of peripheral blood flow in preterm infants matched for gestational age either with infants showing clinical signs of an impaired microcirculation or those without such signs. Microcirculation was assessed noninvasively with NIRP (7).Photoplethysmography was first described by Hertzman and Spealman in 1937 (8). It is a noninvasive technique consisting of a red/infrared light-emitting diode and a photosensitive detector (9). The emitted light is eithe...

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Does red blood cell transfusion change the near infra red photoplethysmography signal in infants?

Cited by 5 publications

References 18 publications

Deformability of transfused red blood cells is a potent determinant of transfusion‐induced change in recipient's blood flow

Deformability of transfused red blood cells is a potent determinant of transfusion‐induced change in recipient's blood flow

Functional Vessel Density in the First Month of Life in Preterm Neonates

Impaired Microvascular Perfusion Improves With Increased Incubator Temperature in Preterm Infants

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