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Am J Perinatol 2017; 34(08): 735-741
DOI: 10.1055/s-0036-1597993
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Use of Esophageal Hemoximetry to Assess the Effect of Packed Red Blood Cell Transfusion on Gastrointestinal Oxygenation in Newborn Infants

Farha M. Vora
1   Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California
,
Judy Gates
1   Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California
,
Kimberley Gerard
2   Department of Pediatrics, University of California, Davis, California
,
Shawn Hanson
1   Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California
,
Richard L. Applegate II
3   Department of Anesthesiology and Pain Medicine, University of California, Davis, California
,
Arlin B. Blood
1   Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California
4   Center for Perinatal Biology, Loma Linda University School of Medicine, Loma Linda, California
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Publikationsverlauf

28. Juli 2016

09. Dezember 2016

Publikationsdatum:
18. Januar 2017 (online)

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Abstract

Objectives There are no widely accepted methods of continuously monitoring gut oxygenation in the newborn during packed red blood cell transfusion. We investigated the use of an orally inserted light spectroscopy probe to measure lower esophageal oxyhemoglobin saturations (eStO2) before, during, and after transfusion and made comparisons with abdominal near-infrared spectroscopy (NIRS) and superior mesenteric artery (SMA) flow.

Study Design Thirteen neonates with corrected gestational ages ranging from 22 weeks, 0 day to 37 weeks, 5 days were enrolled. eStO2 and NIRS measurements were recorded continuously for a 25-hour period starting 1 hour prior to starting the 4-hour transfusion. Transabdominal ultrasound was used to measure SMA flow prior to, upon completion, and 20 hours after the transfusion.

Results Twelve infants completed the study. eStO2 was well-tolerated and was weakly (r = 0.06) correlated (p < 0.001) with NIRS. Compared with NIRS, eStO2 demonstrated a markedly greater variation in oxyhemoglobin values. NIRS and SMA flow measurements did not change, while eStO2 increased from 48 ± 5% and 45 ± 5% in the pre- and intratransfusion periods to 57 ± 4% in the posttransfusion period (p = 0.03).

Conclusion Measurement of eStO2 is feasible in neonates and may provide a continuous and sensitive index of rapid changes in mesenteric oxygenation in this patient population.

Keywords

hemoglobin oximetry - necrotizing enterocolitis - newborn - transfusion - mesenteric blood flow

Supplementary Material

 

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