{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:55:32Z","timestamp":1760147732564,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>In anaemic preterm infants who receive packed red blood cell (PRBC) transfusions, changes to mesenteric tissue oxygenation and perfusion have been reported using a restrictive haemoglobin (Hb)\u2010based threshold. We aimed to investigate changes to hepatic tissue oxygenation and abdominal blood flow after PRBC transfusion <jats:bold>and its association with enteral feeding<\/jats:bold> using a liberal Hb threshold <jats:bold>(as shown in<\/jats:bold><jats:bold>Table<\/jats:bold><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#vox12938-tbl-0001\"><jats:bold>1<\/jats:bold><\/jats:ext-link><jats:bold>).<\/jats:bold><\/jats:p><jats:p><jats:table-wrap>\n\n\n\n<jats:table frame=\"hsides\">\n<jats:col\/>\n<jats:col\/>\n<jats:col\/>\n<jats:col\/>\n<jats:col\/>\n<jats:thead>\n<jats:tr>\n<jats:th>\u00a0<\/jats:th>\n<jats:th>If respiratory support is required<\/jats:th>\n<jats:th>If respiratory support is not required<\/jats:th>\n<\/jats:tr>\n<jats:tr>\n<jats:th>Postnatal age<\/jats:th>\n<jats:th>Capillary haemoglobin (g\/L)<\/jats:th>\n<jats:th>Central haemoglobin (g\/L)<\/jats:th>\n<jats:th>Capillary haemoglobin (g\/L)<\/jats:th>\n<jats:th>Central haemoglobin (g\/L)<\/jats:th>\n<\/jats:tr>\n<\/jats:thead>\n<jats:tbody>\n<jats:tr>\n<jats:td>Days 1\u20107<\/jats:td>\n<jats:td>\u2264 135<\/jats:td>\n<jats:td>\u2264 122<\/jats:td>\n<jats:td>\u2264 120<\/jats:td>\n<jats:td>\u2264 109<\/jats:td>\n<\/jats:tr>\n<jats:tr>\n<jats:td>Days 8\u201014<\/jats:td>\n<jats:td>\u2264 120<\/jats:td>\n<jats:td>\u2264 109<\/jats:td>\n<jats:td>\u2264 100<\/jats:td>\n<jats:td>\u2264 90<\/jats:td>\n<\/jats:tr>\n<jats:tr>\n<jats:td>Days 15 until discharge<\/jats:td>\n<jats:td>\u2264 100<\/jats:td>\n<jats:td>\u2264 90<\/jats:td>\n<jats:td>\u2264 85<\/jats:td>\n<jats:td>\u2264 77<\/jats:td>\n<\/jats:tr>\n<\/jats:tbody>\n<\/jats:table>\n\n<\/jats:table-wrap><\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>We prospectively studied a cohort of preterm infants born at &lt; 32 weeks\u2019 gestation who received at least one PRBC transfusion and monitored them immediately before <jats:bold>(Time 1)<\/jats:bold>, immediately after <jats:bold>(Time 2)<\/jats:bold> and 24\u00a0hours after transfusion <jats:bold>(Time 3)<\/jats:bold>. Data obtained included physiological parameters, the hepatic tissue oxygenation index and pulsed Doppler ultrasound measurements in the abdominal arterial circulation. Additionally, the effects of withholding enteral feeds were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We monitored 50 PRBC transfusion episodes in 40 preterm infants, in whom the mean gestational age was 26.72 weeks (\u00b11.6\u00a0weeks) and the mean birth weight was 855.25\u00a0g (\u00b1190.7\u00a0g). We observed significant changes to pulsed Doppler measurements in abdominal arterial circulation <jats:bold>(coeliac artery mean peak systolic velocity Time 2 [75.08 cm\/sec] versus Time 3 [71.13 cm\/sec]; mean end\u2010diastolic velocity Time 2 [15.71 cm\/sec] versus Time 3 [13.76 cm\/sec]; mean resistive index Time 2 0.78 versus Time 3 0.80, right renal artery mean peak systolic velocity Time 1 58.28 cm\/sec versus Time 2 50.97 cm\/sec, left renal artery mean peak systolic velocity Time 1 49.20 cm\/sec versus Time 2 45.40 cm\/sec)<\/jats:bold>, but not to hepatic tissue oxygenation after PRBC transfusion <jats:bold>(Time 1 mean 53.66 [SD, 13.34]; Time 2 mean 54.93 [SD, 9.3]; Time 3 mean 55.64 [SD, 12.86])<\/jats:bold>. There were no changes to hepatic tissue oxygenation or mesenteric blood flow from withholding enteral feeds during PRBC transfusion. There were no local adverse effects from hepatic tissue oxygenation monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In mildly anaemic preterm infants, when allowing a liberal Hb threshold\u2010based trigger for PRBC transfusion, changes in abdominal arterial circulation were present, but not in hepatic tissue oxygenation. Withholding enteral feeds during PRBC transfusion had no impact on hepatic tissue oxygenation or mesenteric flows.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.12938","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T05:44:52Z","timestamp":1589867092000},"page":"712-721","source":"Crossref","is-referenced-by-count":3,"title":["Changes to hepatic tissue oxygenation, abdominal perfusion and its association with enteral feeding with liberal transfusion threshold in anaemic preterm infants: A prospective cohort study."],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9802-5983","authenticated-orcid":false,"given":"Pranav","family":"Jani","sequence":"first","affiliation":[{"name":"Westmead Hospital Department of Neonatology Westmead NSW Australia"},{"name":"The University of Sydney Sydney NSW 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