The effect of red blood cell transfusion on abdominal and cerebral tissue oxygen saturation and its relation to developing subsequent necrotizing enterocolitis in preterm infants

Kalteren, W. (Willemien) (2016) The effect of red blood cell transfusion on abdominal and cerebral tissue oxygen saturation and its relation to developing subsequent necrotizing enterocolitis in preterm infants. thesis, Medicine.

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Abstract

Background: Preterm infants often need red blood cell (RBC) transfusions due to anemia. Increasing evidence is available concerning the possible association between RBC transfusion and the development of necrotizing enterocolitis (NEC), a severe inflammatory bowel disease. RBC transfusion may result in ischemia-reperfusion injury to the intestinal tissue. Aim: To determine the effect of RBCs on abdominal and cerebral regional tissue oxygen saturation (raSO2 and rcSO2) in preterm infants, as well as on rSO2 variability. To evaluate the supposed association of RBC transfusion, intestinal oxygenation, and NEC development. Methods: For this study we included preterm infants (gestational age < 32 weeks) from three prospective cohorts aimed to assess the value of multisite near-infrared spectroscopy (NIRS) or to predict NEC. We used NIRS to measure raSO2 and rcSO2 before, during and/or after RBC transfusion. Controls, with available NIRS data who did not receive RBC transfusion, were matched on postnatal day of RBC transfusion of index subjects. Variability of rSO2 was determined using the root mean square of successive differences method. Mann Whitney U, Chi square, Wilcoxon signed rank, Friedman test and regression analysis are used for statistical analyses. Results: We did not find any statistical differences in raSO2 and rcSO2 between index (n = 24) and control infants (n = 24). We found lower raSO2 and rcSO2 variability after RBC transfusion compared to controls (7% vs. 12%, p = 0.001 and 4% vs. 5%, p = 0.023). We also found lower rcSO2 values after RBC transfusion in infants who developed NEC compared to infants who did not develop NEC (58% [50 – 63] vs. 72% [65 – 75], p = 0.000). Conclusion: Following RBC transfusion raSO2 values increased, and raSO2 and rcSO2 variability decreased after RBC transfusion. Infants who developed NEC showed lower rcSO2 values after RBC transfusion compared to infants who did not. The data suggest that preterm infants after RBC transfusion may be at higher risk for NEC development.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor of scientific internship: and Kooi, Dr. E.M.W. and Neonatal Intensive Care Unit, Beatrix Children’s Hospital and University of Groningen, University Medical Center Groningen
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:59
Last Modified:	25 Jun 2020 10:59
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1980

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