Effect of blood transfusion on intestinal blood flow and oxygenation in extremely preterm infants during first week of life

Banerjee, Jayanta; Leung, Terence S.; Aladangady, Narendra

doi:10.1111/trf.13434

Cited by 18 publications

(11 citation statements)

References 36 publications

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“…In support of this, EPO has been shown to be protective against NEC [42-44] and one of the hypotheses for this protective effect is secondary to prevention of anaemia of prematurity. Recent Cochrane analyses of early [77] and late [52] rEPO usage concluded that there was a reduction in the number and volume of RBCT but the clinical significance was questioned.…”

Section: Anaemia Blood Transfusion and Necmentioning

confidence: 99%

“…Seidel et al [38] measured crSO 2 and prSO 2 before, during, immediately after, and 24 h after RBCT and noticed a significant improvement in cerebral and peripheral tissue oxygenation and perfusion (correlating with improvement in clinical symptoms of anaemia) upon transfusing those with crSO 2 < 55% compared to ≥55% [38]. Banerjee et al [43, 44] reported that RBCT improves cerebral and gut tissue oxygenation in preterm infants of any post-natal age irrespectively of the feeding pattern, the pre-transfusion Hb, or the presence or absence of PDA [43, 44]. …”

Section: Blood Transfusion and Peripheral Brain And Gut Perfusionmentioning

confidence: 99%

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Red Blood Cell Transfusion in Preterm Infants: Current Evidence and Controversies

2018

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The current evidence regarding the indication, advantages and risks of red blood cell transfusion (RBCT) for preterm infants is discussed. This is an important area in Neonatology to be examined given that 90% of extremely low birth weight infants receive RBCT and many controversies remain regarding when to transfuse and the risks of RBCT. The various treatment thresholds and guidelines used are presented and we compare the short-term clinical benefits of liberal and restrictive RBCT in preterm infants; the majority of these are equivocal and sadly long-term outcome data is limited. The latest evidence on how anaemia and blood transfusion affect organ perfusion in preterm infants is presented. This is important when trying to establish the optimal trigger threshold for RBCT in preterm infants, especially because the knowledge about the adaptive physiological responses to anaemia in very low birth weight infants and the effects of RBCT at various levels of anaemia is also inadequate. Further research into the physiological adaptive response to anaemia of varying degrees and to RBCT at different levels of anaemia in preterm infants of different gestational and post-natal ages is needed before we can conclusively guide the optimal timing and trigger thresholds for RBCT in preterm infants.

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Section: Anaemia Blood Transfusion and Necmentioning

confidence: 99%

Section: Blood Transfusion and Peripheral Brain And Gut Perfusionmentioning

confidence: 99%

Red Blood Cell Transfusion in Preterm Infants: Current Evidence and Controversies

2018

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“…Bhalala et al ( 29 ) reported a decrease of 20 % and more compared to the baseline values. NIRS was recommended to determine the oxygen demand of regional oxygen saturation (rSO 2 ), transfusion requirement, and in the diagnosis of necrotizing enterocolitis (NEC) in neonatal intensive care units ( 5 , 30 – 32 ). Kaufman et al ( 33 ) found a strong correlation between splanchnic rSO2 and gastric pH measurement, mixed venous oxygen saturation, and serum lactate levels in 20 infants who underwent congenital cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Effects of Pneumoperitoneum on Splanchnic Oxygenation during Abdominal Laparoscopic Surgery in Paediatric Patients: A prospective, Observational Study

Kılınç¹,

Türk²,

Sayin³

et al. 2021

Turk J Anaesthesiol Reanim

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Objective Pneumoperitoneum can cause disruption in splanchnic perfusion. This study aims to investigate effects of pneumoperitoneum on splanchnic oxygenation during abdominal laparoscopic surgery in paediatric patients with NIRS (Near-Infrared Spectroscopy). Material and methods A total of 45 patients between 1 and 4 years of age with ASA physical status I–II and scheduled to undergo abdominal laparoscopic surgery under general anaesthesia were enrolled in this prospective, observational surgery. No premedication was used. Standard monitoring and regional splanchnic saturation (rSPcO 2 ), regional cerebral oxygen saturation (rScO 2 ) with NIRS were established before anaesthesia. Anaesthesia was induced with an inhalational agent and maintained with an oxygen/air mixture and sevoflurane. Peripheral oxygen saturation (SPO 2 ), rSPcO 2 , rScO 2 , heart rate (HR), mean arterial pressure (MAP), end tidal CO 2 (Et-CO 2 ), and insufflation pressure (IP) were continuously monitored during administration of anaesthesia and recorded. After intubation (baseline T0); before CO 2 insufflation induced pneumoperitoneum (PP) (T1); CO 2 PP insufflation (T2); 5 minutes after PP insufflation (T3); 10 minutes after PP insufflation (T4); 15 minutes after PP insufflation (T5); 20 minutes after PP insufflation (T6); 30 minutes after PP insufflation (T7), 60 minutes after PP insufflation (T8), and after desufflation (T9). Bradycardia and hypotension were recorded. Paracetamol IV 10 mg kg −1 was applied for post-operative analgesia. p<0.05 wasconsidered significant. Results HR, rScO 2 , and rSPcO 2 decreased at all measured time intervals when compared to T0 (p<0.01) MAP decreased at T1 compared to T0 (p<0.001). Et-CO 2 increased at T3-T4-T5-T6 compared to T0 (p<0.001). Conclusion We found that pneumoperitoneum reduced splanchnic oxygenation during laparoscopic abdominal surgery in paediatric patients, which was measured using NIRS.

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“…The NIRS analysis was completed in 5 minute epochs and any areas within the 60 minute recording deemed to be "noisy" were removed from the analysis under the guidance of a medical physicist in NIRS (TSL). In most NIRS studies around 10% of infants are excluded because of motion artefacts 12,42 , but no baby was excluded because of motion artefact from the present study.…”

Section: Strengths Of the Studymentioning

confidence: 99%

Cerebral Oxygenation in Preterm Infants With Necrotizing Enterocolitis

Howarth

Banerjee

Leung³

et al. 2020

Pediatrics

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Table of Contents Summary: This study demonstrates that infants with NEC have significantly lower cerebral oxygenation which may contribute to the worse neurodevelopmental outcome in these infants. What is already known on this topic: Near infra-red spectroscopy (NIRS) can non-invasively monitor regional oxygenation in preterm infants. Low cerebral oxygenation during the first week of life is associated with poor neurodevelopmental outcomes and Necrotising enterocolitis (NEC) is an independent risk factor for worse neurodevelopmental outcome.

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Effect of blood transfusion on intestinal blood flow and oxygenation in extremely preterm infants during first week of life

Abstract: Blood transfusion increased blood pressure and intestinal tissue oxygenation but did not alter blood flow velocities. Partial feeding had no impact on intestinal blood flow and tissue oxygenation changes.

Cited by 18 publications

References 36 publications

Red Blood Cell Transfusion in Preterm Infants: Current Evidence and Controversies

Red Blood Cell Transfusion in Preterm Infants: Current Evidence and Controversies

Effects of Pneumoperitoneum on Splanchnic Oxygenation during Abdominal Laparoscopic Surgery in Paediatric Patients: A prospective, Observational Study

Cerebral Oxygenation in Preterm Infants With Necrotizing Enterocolitis

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