Packed red blood cells transfusion in neonates: effect on FiO 2 and PaO 2 /SaO 2 ratio, and implications for neonatal saturation targeting

Objectiveto assess the effect of blood transfusions in neonates on partial pressure of oxygen in arterial blood (pao2), arterial hemoglobin oxygen saturation (sao2) and arterial hemoglobin oxygen saturation as measured by pulse oximetry (spo2).study designretrospective study of neonates that received a first blood transfusion while having an indwelling arterial line. we compared pao2, sao2, spo2, sao2/pao2 ratio and fraction of inspired oxygen (fio2) 12 h before and after blood transfusion.resultspost-transfusion neonates had higher pao2 and sao2, had lower sao2/pao2 ratio, and received higher fio2 with no change in spo2.conclusionspost-transfusion, neonates had lower hemoglobin oxygen affinity. they received higher fio2 and had higher pao2 at the same spo2. we speculate that fio2 was increased in order to maintain spo2. larger prospective trials are needed to confirm our findings.