{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T21:37:52Z","timestamp":1769463472377,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Red blood cell (RBC) transfusion is frequently used to treat anemia of prematurity, yet bedside metrics that capture its short-term impact on oxygenation stability are limited. We assessed whether pulse oximetry histogram-derived oxygen saturation (SpO2) exposure changes after transfusion and whether responses differ across clinical subgroups. Methods: This prospective observational cohort included preterm infants born &lt;32 weeks\u2019 gestation who received a standardized RBC transfusion (15 mL\/kg). Continuous SpO2 histograms quantified the percentage of monitored time spent in hypoxemia (&lt;85%), normoxemia (86\u201395%), and hyperoxemia (\u226596%) during four intervals: 24 h pre-transfusion and 24, 48, and 72 h post-transfusion. Repeated-measures and subgroup analyses (BPD, sex, birth weight &lt; 1000 g) were performed. Results: Thirty-three infants were analyzed (gestational age 29.4 \u00b1 2.1 weeks; birth weight 1220.6 \u00b1 316.9 g). Hemoglobin increased from 8.6 \u00b1 1.1 to 11.7 \u00b1 1.0 g\/dL (p &lt; 0.001). Cohort-level histogram shifts were modest: normoxemia increased from 68.4 \u00b1 12.1% to 72.6 \u00b1 11.4% at 24 h (p = 0.18), hypoxemia decreased from 10.3 \u00b1 6.5% to 6.6 \u00b1 4.8% (p = 0.09), and hyperoxemia remained stable (21.3 \u00b1 9.2% to 20.8 \u00b1 8.5%; p = 0.44). Infants with BPD and those &lt;1000 g showed persistently higher hypoxemia and\/or hyperoxemia at 72 h compared with counterparts. Exploratory ROC analyses showed modest discrimination of 24 h hypoxemia for ROP (AUC 0.71) and 72 h hyperoxemia for BPD (AUC 0.74). Conclusions: RBC transfusion corrected anemia but did not produce a consistent cohort-level improvement in SpO2 histogram stability. Histogram metrics may help characterize heterogeneous oxygenation responses and support hypothesis generation for individualized monitoring strategies.<\/jats:p>","DOI":"10.3390\/children13020167","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:24:36Z","timestamp":1769423076000},"page":"167","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulse Oximetry Histogram Profiles Before and After Red Blood Cell Transfusion in Very Preterm Infants: A Prospective Observational Cohort"],"prefix":"10.3390","volume":"13","author":[{"given":"Nevra","family":"\u00c7olak","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Sel\u00e7uklu Medical Faculty, Sel\u00e7uk University, Konya 42000, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-4541","authenticated-orcid":false,"given":"Murat","family":"Konak","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Sel\u00e7uklu Medical Faculty, Sel\u00e7uk University, Konya 42000, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saime S\u00fcnd\u00fcs","family":"Uygun","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Sel\u00e7uklu Medical Faculty, Sel\u00e7uk University, Konya 42000, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/vox.13036","article-title":"Neonatal red blood cell transfusion","volume":"116","author":"Villeneuve","year":"2021","journal-title":"Vox Sang."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1007\/s00431-004-1448-3","article-title":"Haemodynamic effects of erythrocyte transfusion in preterm infants","volume":"163","author":"Boldt","year":"2004","journal-title":"Eur. 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