Assessment of Tissue Oxygenation Pre- and Post Blood Transfusion in Preterm Infants Using Abdominal Site Near-Infrared Spectroscopy

Thursday, 15 July 2010

Harriet D. Miller, PhD, ARNP1
Ann Diaz, RN, BSN, MA2
Kari Baumann, BSN, RN2
Laura Hubbard, BSN, RN2
Susan Soderberg, BSN, RN3
1Advanced Practice Nursing & Research, Orlando Health, Orlando, FL
2Winnie Palmer Hospital for Women and Babies, Orlando Health, Orlando, FL
3Winnie Palmer Hospital for Women and Babies, Orlando Health, Orlandof, FL

Learning Objective 1: The learner will be able to discuss the relationship between mesenteric oxygenation and possible complications.

Learning Objective 2: The learner will be able to discuss the relationship between oxygen saturation and blood transfusions.

Regional mesenteric oxygen desaturation is associated with mesenteric ischemia and the complication of necrotizing entercolitis (Stapleton, 2008). In an effort to improve tissue oxygen delivery, infants often receive infusions of packed red blood cells.  It has been shown that there is a statistically significant decrease in tissue oxygenation throughout the blood transfusion, despite an absence of changes in vital signs and oxygen saturations (Petrova & Mehta, 2006). 
Purpose: To investigate the effect of the administration of packed red blood cells on regional abdominal tissue perfusion and regional oxygen saturation (rSO2) using near-infrared spectroscopy (NIRS) in premature infants. 
Design:  A repeated measures design, observational, nonrandomized study.
Methods: Thirty infants who meet the inclusion criteria will be chosen by convenience sampling from a 112 bed tertiary neonatal intensive care unit located in central Florida.  Regional oxygen saturation values in the mesenteric region will be measured continuously using NIRS.  The heart rate (HR) and oxygen saturation (SpO2) values will be extracted from the cardio-respiratory monitor.  The rSO2, HR, and SpO2 will be compared every five minutes two hours before the transfusion, during the transfusion, and four hours after the transfusion.  A multivariate repeated-measures analysis of variance will be performed to detect statistical differences from baseline in tissue saturations during the different time periods. 
Results: No findings are available at present.
Conclusion: Evaluation of the NIRS measurements may help in the development of strategies for managing preterm infants before, during, and after the transfusion of blood.
Petrova, A. & Mehta, R. (2006). Near-infrared spectroscopy in the detection of regional tissue oxygenation during hypoxic events in preterm infants undergoing critical care.  Pediatric Critical Care Medicine, 7(5), 449-454.
Stapleton, G., Eble, B., Dickerson, H., Andropoulos, D., & Chang, A. (2008).  Mesenteric oxygen desaturation in an infant with CHD and NEC, Texas Heart Institute Journal, 34(4), 442-44