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Blood transfusions in preterm infants: changes on perfusion index and intermittent hypoxemia
Author(s) -
Ibonia Katrina T.,
Bada Henrietta S.,
Westgate Philip M.,
GomezPomar Enrique,
Bhandary Prasad,
Patwardhan Abhijit,
Abu Jawdeh Elie G.
Publication year - 2018
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14808
Subject(s) - medicine , hypoxemia , perfusion , oxygenation , anesthesia , oxygen saturation , oxygenation index , gestation , cardiology , oxygen , pregnancy , chemistry , organic chemistry , biology , genetics
BACKGROUND Red blood cell (RBC) transfusion decreases intermittent hypoxemia (IH) events beyond the first week of life. This benefit may be related to improved perfusion to the respiratory control network. Perfusion index (PI) is a perfusion measure provided by the pulse oximeter. We hypothesized that the benefit in IH after RBC transfusion is associated with an increase in PI. In addition, we assessed the value of PI and clinical measures in predicting the effect of RBC transfusion on IH. STUDY DESIGN AND METHODS We prospectively enrolled infants less than 30 weeks' gestation age. PI and oxygen saturation (SpO 2 ) were monitored with high‐resolution pulse oximeters 24 hours before and after RBC transfusion. Data were analyzed at three postnatal periods: Epoch 1, first week of life (1 to 7 days of life); Epoch 2, 2 to 4 weeks of life (8 to 28 days of life); and Epoch 3, 4 to 8 weeks of life. RESULTS A total of 118 transfusions were analyzed. IH measures significantly decreased after transfusion in Epochs 2 and 3. PI significantly increased after transfusion, but it did not correlate with the decrease in IH measures. Mechanical ventilation, fraction of inspired oxygen (FiO 2 ), and IH measures influenced the effects on oxygenation. CONCLUSIONS RBC transfusion improved IH after the first week of life. The benefit in IH did not correlate with PI increase after transfusion. Pretransfusion respiratory support and IH measures predicted the effect of transfusion on oxygenation.