Progressive anemia of prematurity is associated with a critical increase in cerebral oxygen extraction.
Early Hum Dev
; 140: 104891, 2020 Jan.
Article
em En
| MEDLINE
| ID: mdl-31669878
ABSTRACT
BACKGROUND:
Elevated cerebral fractional tissue oxygen extraction (cFTOE) is an adaptation to anemia of prematurity (AOP). cFTOE ≥0.4 is associated with brain injury in infants ≤30â¯weeks. This longitudinal study sought to investigate the utility of cFTOE in the evaluation of AOP.METHODS:
Infants ≤30â¯weeks estimated gestational age (EGA) underwent weekly hemoglobin, cerebral saturation, and pulse oximetry recordings from the second through 36â¯weeks post-menstrual age (PMA). Recordings were excluded if they were under 1â¯h or if hemoglobin was not measured within 7â¯days of recording. Mean cFTOE was calculated for each recording. Statistical analysis used linear mixed-effects modeling and receiver operating characteristic analysis.RESULTS:
144 recordings from 39 infants (mean EGA 27.6⯱â¯2.2â¯weeks, BW 1139⯱â¯286â¯g) were included of whom 39% (15/39) were transfused. The mean recording length was 2.8⯱â¯1.3â¯h. There was a significant negative correlation between hemoglobin and cFTOE (Râ¯=â¯-0.423, pâ¯≤.001). In a multivariate model, adjusting for EGA, PMA, and patent ductus arteriosus treatment the AUC was 0.821. A critical increase in cFTOE occurred at a hemoglobin level of 9.6â¯g/dL.CONCLUSIONS:
AOP is associated with a critical increase in cFTOE that occurs at a significantly higher hemoglobin level than standard clinical thresholds for transfusion.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article