{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:22:24Z","timestamp":1792790544037,"version":"4.5.0"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold>Anemia remains a common comorbidity of preterm infants in the neonatal intensive care unit (NICU). Left untreated, severe anemia may adversely affect organ function due to inadequate oxygen supply to meet oxygen requirements, resulting in hypoxic tissue injury, including cerebral tissue. To prevent hypoxic tissue injury, anemia is generally treated with packed red blood cell (RBC) transfusions. Previously published data raise concerns about the impact of anemia on cerebral oxygen delivery and, therefore, on neurodevelopmental outcome (NDO).<\/jats:p><jats:p><jats:bold>Objective:<\/jats:bold>To provide a systematic overview of the impact of anemia and RBC transfusions during NICU admission on cerebral oxygenation, measured using near-infrared spectroscopy (NIRS), brain injury and development, and NDO in preterm infants.<\/jats:p><jats:p><jats:bold>Data Sources:<\/jats:bold>PubMed, Embase, reference lists.<\/jats:p><jats:p><jats:bold>Study Selection:<\/jats:bold>We conducted 3 different searches for English literature between 2000 and 2020; 1 for anemia, RBC transfusions, and cerebral oxygenation, 1 for anemia, RBC transfusions, and brain injury and development, and 1 for anemia, RBC transfusions, and NDO.<\/jats:p><jats:p><jats:bold>Data Extraction:<\/jats:bold>Two authors independently screened sources and extracted data. Quality of case-control studies or cohort studies, and RCTs was assessed using either the Newcastle-Ottawa Quality Assessment Scale or the Van Tulder Scale, respectively.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold>Anemia results in decreased oxygen-carrying capacity, worsening the burden of cerebral hypoxia in preterm infants. RBC transfusions increase cerebral oxygenation. Improved brain development may be supported by avoidance of cerebral hypoxia, although restrictive RBC transfusion strategies were associated with better long-term neurodevelopmental outcomes.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold>This review demonstrated that anemia and RBC transfusions were associated with cerebral oxygenation, brain injury and development and NDO in preterm infants. Individualized care regarding RBC transfusions during NICU admission, with attention to cerebral tissue oxygen saturation, seems reasonable and needs further investigation to improve both short-term effects and long-term neurodevelopment of preterm infants.<\/jats:p>","DOI":"10.3389\/fped.2021.644462","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T05:14:56Z","timestamp":1614316496000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":53,"title":["Anemia and Red Blood Cell Transfusions, Cerebral Oxygenation, Brain Injury and Development, and Neurodevelopmental Outcome in Preterm Infants: A Systematic Review"],"prefix":"10.3389","volume":"9","author":[{"given":"Willemien S.","family":"Kalteren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise A.","family":"Verhagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Mintzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arend F.","family":"Bos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth M. W.","family":"Kooi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1001\/jama.2016.1204","article-title":"Association of red blood cell transfusion, anemia, and necrotizing enterocolitis in very low-birth-weight infants","volume":"315","author":"Patel","year":"2016","journal-title":"JAMA."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.siny.2015.12.001","article-title":"Anemia and transfusion in the neonate","volume":"21","author":"Colombatti","year":"2016","journal-title":"Semin Fetal Neonatal Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.jpeds.2009.02.026","article-title":"Effects of transfusions in extremely low birth weight infants: a retrospective study","volume":"155","author":"Valieva","year":"2009","journal-title":"J Pediatr."},{"key":"B4","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.siny.2008.02.009","article-title":"Neonatal anemia","volume":"13","author":"Aher","year":"2008","journal-title":"Semin Fetal Neonatal Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"227","DOI":"10.2450\/2012.0171-11","article-title":"Effects of anaemia on haemodynamic and clinical parameters in apparently stable preterm infants","volume":"11","author":"Quante","year":"2013","journal-title":"Blood Transfus."},{"key":"B6","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1542\/peds.112.4.838","article-title":"Hemodynamic changes in anemic premature infants: are we allowing the hematocrits to fall to low?","volume":"112","author":"Alkalay","year":"2003","journal-title":"Pediatrics."},{"key":"B7","doi-asserted-by":"publisher","first-page":"F352","DOI":"10.1136\/adc.2009.163592","article-title":"Cerebral tissue oxygen saturation and extraction in preterm infants before and after blood transfusion","volume":"95","author":"Van Hoften","year":"2010","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"key":"B8","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/j.jpeds.2013.10.041","article-title":"Early cerebral oxygen extraction and the risk of death or sonographic brain injury in very preterm infants","volume":"164","author":"Balegar","year":"2014","journal-title":"J Pediatr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1542\/peds.2005-3197","article-title":"Poor circulation, early brain injury, and the potential role of red cell transfusion in premature newborns","volume":"117","author":"Andersen","year":"2006","journal-title":"Pediatrics."},{"key":"B10","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1001\/jamapediatrics.2016.1210","article-title":"Neurodevelopmental outcomes among extremely preterm infants 6.5 years after active perinatal care in Sweden","volume":"170","author":"Serenius","year":"2016","journal-title":"JAMA Pediatr."},{"key":"B11","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1111\/dmcn.12622","article-title":"Cerebral oxygenation is associated with neurodevelopmental outcome of preterm children at age 2 to 3 years","volume":"57","author":"Verhagen","year":"2015","journal-title":"Dev Med Child Neurol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/S0140-6736(08)60136-1","article-title":"An overview of mortality and sequelae of preterm birth from infancy to adulthood","volume":"371","author":"Saigal","year":"2008","journal-title":"Lancet."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2190","DOI":"10.1001\/jama.2018.5725","article-title":"Association between oxygen saturation targeting and death or disability in extremely preterm infants in the neonatal oxygenation prospective meta-analysis collaboration","volume":"319","author":"Askie","year":"2018","journal-title":"JAMA."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e20161117","DOI":"10.1542\/peds.2016-1117","article-title":"A theoretical and practical approach to defining Adequate oxygenation in the preterm newborn","volume":"139","author":"Andersen","year":"2017","journal-title":"Pediatrics."},{"key":"B15","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1111\/j.1651-2227.2002.tb02881.x","article-title":"Effect of blood transfusions on cerebral haemodynamics in preterm infants","volume":"91","author":"Dani","year":"2002","journal-title":"Acta Paediatr."},{"key":"B16","doi-asserted-by":"publisher","first-page":"6.e1","DOI":"10.1016\/j.jpeds.2011.02.040","article-title":"Red blood cell transfusions are independently associated with intra-hospital mortality in very low birth weight preterm infants","volume":"159","author":"Nunes dos Santos","year":"2011","journal-title":"J Pediatr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2639","DOI":"10.1056\/NEJMoa2020248","article-title":"Higher or lower hemoglobin transfusion thresholds for preterm infants","volume":"383","author":"Kirpalani","year":"2020","journal-title":"N Engl J Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1001\/jama.2020.10690","article-title":"Effects of liberal vs restrictive transfusion thresholds on survival and neurocognitive outcomes in extremely low-birth-weight infants: the ETTNO randomized clinical trial","volume":"324","author":"Franz","year":"2020","journal-title":"JAMA."},{"key":"B19","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.jpeds.2006.05.011","article-title":"The premature infants in need of transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants","volume":"149","author":"Kirpalani","year":"2006","journal-title":"J Pediatr."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1542\/peds.2004-1884","article-title":"Randomized trial of liberal versus restrictive guidelines for red blood cell transfusion in preterm infants","volume":"115","author":"Bell","year":"2005","journal-title":"Pediatrics."},{"key":"B21","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1159\/000499048","article-title":"What is new about transfusions for preterm infants? An update","volume":"115","author":"Kirpalani","year":"2019","journal-title":"Neonatology."},{"key":"B22","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1159\/000486584","article-title":"Red blood cell transfusion in preterm infants: current evidence and controversies","volume":"114","author":"Howarth","year":"2018","journal-title":"Neonatology."},{"key":"B23","doi-asserted-by":"publisher","first-page":"CD011190","DOI":"10.1002\/14651858.CD011190.pub2","article-title":"Effects of targeting lower versus higher arterial oxygen saturations on death or disability in preterm infants","volume":"4","author":"Askie","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"B24","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1038\/s41390-019-0466-9","article-title":"Regional tissue oxygenation monitoring in the neonatal intensive care unit: evidence for clinical strategies and future directions","volume":"86","author":"Mintzer","year":"2019","journal-title":"Pediatr Res."},{"key":"B25","doi-asserted-by":"publisher","first-page":"94","DOI":"10.3390\/children5070094","article-title":"Interpretation of cerebral oxygenation changes in the preterm infant","volume":"5","author":"Garvey","year":"2018","journal-title":"Children"},{"key":"B26","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1038\/s41390-018-0026-8","article-title":"Monitoring cerebral oxygenation of the immature brain: a neuroprotective strategy?","volume":"84","author":"Van Bel","year":"2018","journal-title":"Pediatr Res."},{"key":"B27","doi-asserted-by":"publisher","first-page":"2574","DOI":"10.1111\/trf.12670","article-title":"Biomarkers to decide red blood cell transfusion in newborn infants","volume":"54","author":"Banerjee","year":"2014","journal-title":"Transfusion."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1097\/01.BRS.0000065484.95996.AF","article-title":"Updated method guidelines for systematic reviews in the cochrane collaboration back review group","volume":"28","author":"van Tulder","year":"2003","journal-title":"Spine."},{"key":"B30","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1111\/trf.15680","article-title":"Influence of enteral feeding and anemia on tissue oxygen extraction after red blood cell transfusion in preterm infants","volume":"60","author":"Goldstein","year":"2020","journal-title":"Transfusion."},{"key":"B31","doi-asserted-by":"publisher","first-page":"104891","DOI":"10.1016\/j.earlhumdev.2019.104891","article-title":"Progressive anemia of prematurity is associated with a critical increase in cerebral oxygen extraction","volume":"140","author":"Whitehead","year":"2019","journal-title":"Early Hum Dev."},{"key":"B32","doi-asserted-by":"publisher","first-page":"3093","DOI":"10.1111\/trf.15452","article-title":"Liberal hemoglobin threshold affects cerebral arterial pulsed doppler and cardiac output, not cerebral tissue oxygenation: a prospective cohort study in anemic preterm infants","volume":"59","author":"Jani","year":"2019","journal-title":"Transfusion."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1111\/jpc.14378","article-title":"Effects of blood transfusion on regional tissue oxygenation in preterm newborns are dependent on the degree of anemia","volume":"55","author":"Aktas","year":"2019","journal-title":"J Paediatr Child Health."},{"key":"B34","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1038\/s41390-018-0266-7","article-title":"Cerebral oxygenation in preterm infants receiving transfusion","volume":"85","author":"Jain","year":"2019","journal-title":"Pediatr Res."},{"key":"B35","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1111\/apa.14631","article-title":"Cerebral oxygenation and cardiorespiratory stability following liberal transfusion in preterm neonates","volume":"108","author":"Saito-Benz","year":"2019","journal-title":"Acta Paediatr."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1055\/s-0038-1636532","article-title":"Red blood cell transfusions affect intestinal and cerebral oxygenation differently in preterm infants with and without subsequent necrotizing enterocolitis","volume":"35","author":"Kalteren","year":"2018","journal-title":"Am J Perinatol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1055\/s-0038-1660458","article-title":"Regional tissue oxygen extraction and severity of anemia in very low birth weight neonates: a pilot NIRS analysis","volume":"35","author":"Mintzer","year":"2018","journal-title":"Am J Perinatol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1038\/s41372-018-0120-0","article-title":"Anemia of prematurity and cerebral near-infrared spectroscopy: should transfusion thresholds in preterm infants be revised?","volume":"38","author":"Whitehead","year":"2018","journal-title":"J Perinatol."},{"key":"B39","first-page":"2974","article-title":"Effect of anemia and blood transfusion on tissue oxygen saturation and blood pressure in very preterm infants","volume":"10","author":"Li","year":"2017","journal-title":"Int J Clin Exp Med."},{"key":"B40","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1055\/s-0036-1572542","article-title":"Brain maturity and variation of oxygen extraction in premature infants","volume":"33","author":"El-Dib","year":"2016","journal-title":"Am J Perinatol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.earlhumdev.2015.10.017","article-title":"Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants","volume":"97","author":"Banerjee","year":"2016","journal-title":"Early Hum Dev."},{"key":"B42","doi-asserted-by":"publisher","first-page":"F433","DOI":"10.1136\/archdischild-2014-307565","article-title":"Early red cell transfusion favourably alters cerebral oxygen extraction in very preterm newborns","volume":"100","author":"Andersen","year":"2015","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"key":"B43","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3233\/NPM-1477213","article-title":"Monitoring regional tissue oxygen extraction in neonates <1250 g helps identify transfusion thresholds independent of hematocrit","volume":"7","author":"Mintzer","year":"2014","journal-title":"J Neonatal Perinatal Med."},{"key":"B44","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1111\/trf.12359","article-title":"Assessment of red blood cell transfusion and transfusion duration on cerebral and mesenteric oxygenation using near-infrared spectroscopy in preterm infants with symptomatic anemia","volume":"54","author":"Sandal","year":"2014","journal-title":"Transfusion."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1111\/j.1537-2995.2012.03953.x","article-title":"The effect of blood transfusion on cerebral hemodynamics in preterm infants","volume":"53","author":"Koyano","year":"2013","journal-title":"Transfusion."},{"key":"B46","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1038\/jp.2012.108","article-title":"Changes in regional tissue oxygenation saturation and desaturations after red blood cell transfusion in preterm infants","volume":"33","author":"Seidel","year":"2013","journal-title":"J Perinatol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1055\/s-0030-1247598","article-title":"Packed red blood cell transfusion increases regional cerebral and splanchnic tissue oxygen saturation in anemic symptomatic preterm infants","volume":"27","author":"Bailey","year":"2010","journal-title":"Am J Perinatol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1111\/j.1537-2995.2009.02575.x","article-title":"Blood transfusions increase cerebral, splanchnic, and renal oxygenation in anemic preterm infants","volume":"50","author":"Dani","year":"2010","journal-title":"Transfusion."},{"key":"B49","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1097\/00004647-200002000-00008","article-title":"Determinants of cerebral fractional oxygen extraction using near infrared spectroscopy in preterm neonates","volume":"20","author":"Wardle","year":"2000","journal-title":"J Cereb Blood Flow Metab."},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.2450\/2020.0207-20","article-title":"Red blood cell transfusions in preterm newborns and neurodevelopmental outcomes at 2 and 5 years of age","author":"Fontana","year":"2020","journal-title":"Blood Transfus"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14767058.2019.1683157","article-title":"Long-term outcome of brain structure in female preterm infants: possible associations of liberal versus restrictive red blood cell transfusions","volume":"13","author":"Benavides","year":"2019","journal-title":"J Matern Fetal Neonatal Med."},{"key":"B52","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.1038\/s41372-018-0229-1","article-title":"Elevated brain oxygen extraction fraction in preterm newborns with anemia measured using noninvasive MRI","volume":"38","author":"Morris","year":"2018","journal-title":"J Perinatol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1080\/87565641.2013.874428","article-title":"The relationship between brain structure and cognition in transfused preterm children at school age","volume":"39","author":"McCoy","year":"2014","journal-title":"Dev Neuropsychol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1001\/archpediatrics.2010.269","article-title":"Long-term outcome of brain structure in premature infants: effects of liberal vs restricted red blood cell transfusions","volume":"165","author":"Nopoulos","year":"2011","journal-title":"Arch Pediatr Adolesc Med."},{"key":"B55","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/S1875-9572(09)60045-0","article-title":"Effect of blood transfusions on the outcome of very low birth weight preterm infants under two different transfusion criteria","volume":"50","author":"Chen","year":"2009","journal-title":"Pediatr Neonatol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/j.pedneo.2016.03.009","article-title":"Red blood cell transfusion and clinical outcomes in extremely low birth weight preterm infants","volume":"58","author":"Wang","year":"2017","journal-title":"Pediatr Neonatol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.ridd.2015.07.014","article-title":"Bayley-III scales at 12 months of corrected age in preterm infants: patterns of developmental performance and correlations to environmental and biological influences","author":"Velikos","year":"2015","journal-title":"Res Dev Disabil."},{"key":"B58","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1080\/09297049.2010.544647","article-title":"Neurocognitive profiles of preterm infants randomly assigned to lower or higher hematocrit thresholds for transfusion","volume":"17","author":"McCoy","year":"2011","journal-title":"Child Neuropsychol."},{"key":"B59","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/1471-2431-11-48","article-title":"Long-term outcome in relationship to neonatal transfusion volume in extremely premature infants: a comparative cohort study","volume":"11","author":"Von Lindern","year":"2011","journal-title":"BMC Pediatr."},{"key":"B60","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1542\/peds.2008-0338","article-title":"Neurodevelopmental outcome of extremely low birth weight infants randomly assigned to restrictive or liberal hemoglobin thresholds for blood transfusion","volume":"123","author":"Whyte","year":"2009","journal-title":"Pediatrics."},{"key":"B61","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1111\/j.1651-2227.2002.tb02836.x","article-title":"Large variability in performance IQ associated with postnatal morbidity, and reduced verbal IQ among school-aged children born preterm","volume":"91","author":"Gabrielson","year":"2002","journal-title":"Acta Paediatr."},{"key":"B62","doi-asserted-by":"publisher","first-page":"CD011506","DOI":"10.1002\/14651858.CD011506.pub2","article-title":"Cerebral near-infrared spectroscopy monitoring for prevention of brain injury in very preterm infants","volume":"9","author":"Hyttel-Sorensen","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"B63","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/978-1-4615-0205-0_63","article-title":"Measurements of tissue oxygenation index during the first three days in premature born infants","volume":"510","author":"Naulaers","year":"2003","journal-title":"Adv Exp Med Biol."},{"key":"B64","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1651-2227.1989.tb11279.x","article-title":"Effect of PaCO2 and haemoglobin concentration on day to day variation of CBF in preterm neonates","volume":"360","author":"Pryds","year":"1989","journal-title":"Acta Paediatr Scand Suppl."},{"key":"B65","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1056\/NEJMoa1907423","article-title":"A randomized trial of erythropoietin for neuroprotection in preterm infants","volume":"382","author":"Juul","year":"2020","journal-title":"N Engl J Med."},{"key":"B66","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1001\/jamapediatrics.2020.2271","article-title":"Effect of high-dose erythropoietin on blood transfusions in extremely low gestational age neonates: post hoc analysis of a randomized clinical trial","volume":"174","author":"Juul","year":"2020","journal-title":"JAMA Pediatr."},{"key":"B67","doi-asserted-by":"publisher","first-page":"CD004863","DOI":"10.1002\/14651858.CD004863.pub6","article-title":"Early erythropoiesis-stimulating agents in preterm or low birth weight infants","volume":"2","author":"Ohlsson","year":"2020","journal-title":"Cochrane Database Syst Rev."},{"key":"B68","doi-asserted-by":"publisher","first-page":"CD004868","DOI":"10.1002\/14651858.CD004868.pub6","article-title":"Late erythropoiesis-stimulating agents to prevent red blood cell transfusion in preterm or low birth weight infants","volume":"1","author":"Aher","year":"2020","journal-title":"Cochrane Database Syst Rev."},{"key":"B69","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1542\/peds.92.1.99","article-title":"Cerebral oxygen metabolism in newborns","volume":"92","author":"Altman","year":"1993","journal-title":"Pediatrics."},{"key":"B70","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1038\/pr.2015.186","article-title":"Reference values of regional cerebral oxygen saturation during the first 3 days of life in preterm neonates","volume":"79","author":"Alderliesten","year":"2016","journal-title":"Pediatr Res."},{"key":"B71","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1038\/pr.2013.133","article-title":"Comparing near-infrared spectroscopy devices and their sensors for monitoring regional cerebral oxygen saturation in the neonate","volume":"74","author":"Dix","year":"2013","journal-title":"Pediatr Res."},{"key":"B72","first-page":"A4533","article-title":"Clinical use of cerebral oximetry in extremely preterm infants is feasible","volume":"60","author":"Hyttel-Sorensen","year":"2013","journal-title":"Dan Med J."},{"key":"B73","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1038\/jp.2010.71","article-title":"Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants","volume":"31","author":"McNeill","year":"2011","journal-title":"J Perinatol."},{"key":"B74","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.jpeds.2018.11.038","article-title":"Low cerebral oxygenation in preterm infants is associated with adverse neurodevelopmental outcome","volume":"207","author":"Alderliesten","year":"2019","journal-title":"J Pediatr."},{"key":"B75","doi-asserted-by":"publisher","first-page":"054005","DOI":"10.1117\/1.2357730","article-title":"Precision of measurement of cerebral tissue oxygenation index using near-infrared spectroscopy in preterm neonates","volume":"11","author":"Sorensen","year":"2006","journal-title":"J Biomed Opt."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.644462\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T01:49:04Z","timestamp":1671414544000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.644462\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,26]]},"references-count":75,"alternative-id":["10.3389\/fped.2021.644462"],"URL":"https:\/\/doi.org\/10.3389\/fped.2021.644462","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,26]]},"article-number":"644462"}}