Abstracts

Share on facebook
Share on twitter
Share on linkedin

Blood Transfusion Causes More Profound Changes In Splanchnic Oxygenation Compared With Brain

Authors
Ceri Murphy, Jayanta Banerjee, Terence Leung, Narendra Aladangady

Institution(s)
1.Homerton University Hospital NHS trust, London, UK 4.Imperial College London, London, UK
2.Queen Mary University of London, London, UK 5.University College London, London, UK
3.Imperial College Healthcare NHS Trust, London, UK

Introduction
Blood transfusion (BT) improves cerebral1 and gut2 tissue perfusion in preterm infants. Retrospective and cohort observational studies have indicated that pre-existing anaemia as well as BT may lead to necrotising enterocolitis.3 The objective of this study was to measure the relative changes in cerebral and splanchnic tissue oxygenation following blood transfusion using Near Infra-Red Spectroscopy (NIRS) in preterm infants.

Methods
Preterm infants with clinical indication for BT were studied; pre-existing Grade 3 or 4 IVH or gut abnormality were excluded. Infants were recruited to three postnatal age groups: 1-7 (group 1); 8-28 (group 2) and ≥29 days of life
(group 3). Simultaneous cerebral and gut tissue oxygenation index (TOI) and fractional tissue oxygen extraction (FTOE) were measured using NIRS 15 minutes before, during and 15 minutes post-BT. Descriptive analysis and t-tests were performed using SPSS 22.0. Ethical approval and parental consent were obtained.

Results
A total of 59 preterm infants receiving transfusion were recruited to the three postnatal age groups: Group 1; n=20, Group 2; n=21 and Group 3; n=18. The median (range) gestational ages were 26 (23 – 27), 25 (23 – 30) and 26 (24 – 34) weeks and birth weight 763 (600 – 1180), 740 (600 – 1240) and 793 (520 – 1746) grams for the respective postnatal age groups. The cerebral TOI increased significantly (p<0.05) by 5%, 11% and 12% following blood transfusion in Group 1, Group 2 and Group 3 respectively; whilst splanchnic TOI increased significantly (p<0.05) by 42%, 29% and 30% in those postnatal age groups respectively. Both the cerebral and splanchnic FTOE decreased after blood transfusion in all groups but more so in the splanchnic tissue. On multivariate analysis, changes in TOI following blood transfusion were not associated with PDA, feeding and pretransfusion Hb.

Conclusions
The results indicate that the improvement of splanchnic tissue oxygenation following transfusion was more pronounced compared to cerebral oxygenation. This could be an adaptive mechanism of reduced splanchnic tissue perfusion in response to anaemia and sparing of brain perfusion.

References
(1)Banerjee J, Leung T and Aladangady N. Early Hum Dev, 2016; (2)Banerjee J, Leung T, and Aladangady N.Vox Sang, 2016. & (3)Patel R.M., et al. JAMA, 2016.

More to explorer

Summer Meeting 2024

19th-21st June 2024 Joint Summer Meeting with the Fetal and Neonatal Physiological Society at University of Nottingham Full 3-day, International Conference |

Spring Meeting 2024

14th March 2024 Hybrid event: Virtual meeting or in person at Royal Society of Medicine, London 09.30 – 18.00 GMT Register Here

Autumn Meeting 2023

9th November 2023 Hybrid event: This will be a hybrid meeting with both in-person attendance at the Royal Society of Medicine, London

Search by category

We use cookies to improve your experience on our website. By browsing this website, you agree to our use of cookies.