Changes in regional tissue oxygenation saturation and desaturations after red blood cell transfusion in preterm infants

Objective:the study investigated the ability of near-infrared spectroscopy (nirs) to detect subgroups of preterm infants who benefit most from red blood cell (rbc) transfusion in regard to cerebral/renal tissue oxygenation (i) and the number of general oxygen desaturation below 80% (sao2 <80%) (ii).study design:cerebral regional (crso2) and peripheral regional (prso2) nirs parameters were recorded before, during, immediately after and 24 h after transfusion in 76 infants. simultaneously, sao2 <80% were recorded by pulse oximetry. to answer the basic question of the study, all preterm infants were divided into two subgroups according to their pretransfusion crso2 values (<55% and ⩾55%). this cutoff was determined by a k-means clustering analysis.result:crso2 and prso2 increased significantly in the whole study population. a stronger increase (p<0.0005) of both was found in the subgroup with pretransfusion crso2 values <55%. regarding the whole population, a significant decrease (p<0.05) of episodes with sao2 <80% was observed. the subgroup with crso2 baselines <55% had significant (p<0.05) more episodes with sao2 <80% before transfusion. during and after transfusion, the frequency of episodes with sao2 <80% decreased more in this group compared with the group with crso2 baselines ⩾55%.conclusion:nirs measurement is a simple, non-invasive method to monitor regional tissue oxygenation and the efficacy of rbc transfusion. infants with low initial nirs values benefited most from blood transfusions regarding sao2 <80%, which may be important for their general outcome.