TY - JOUR AU - Mintzer, Jonathan P.; Parvez, Boriana; La Gamma, Edmund F. TI - Regional Tissue Oxygen Extraction and Severity of Anemia in Very Low Birth Weight Neonates: A Pilot NIRS Analysis SN - 0735-1631 SN - 1098-8785 PY - 2018 JO - Am J Perinatol JF - American Journal of Perinatology LA - EN VL - 35 IS - 14 SP - 1411 EP - 1418 ET - 2018/06/15 DA - 2018/11/20 KW - anemia KW - hematocrit KW - neonate KW - near-infrared spectroscopy KW - oxygen extraction KW - regional oxygenation AB - Objective Anemia causes blood flow redistribution and altered tissue metabolic behavior to sustain homeostatic oxygen consumption. We hypothesized that anemia severity would correlate with increased regional fractional tissue oxygen extraction among premature neonates.Study Design Regional oxygen extraction was calculated using pulse oximetry and near-infrared spectroscopy data among neonates <1,250 g during their first 10 postnatal days. Oxygen extraction was assessed for correlations with raw hematocrit levels and following grouping into hematocrit quartiles.Results Twenty-seven neonates with gestational age 27 ± 2 weeks and birth weight 966 ± 181 g underwent 116 hematocrit determinations. Cerebral and flank oxygen extraction inversely correlated with hematocrit (cerebral r = −0.527, p = 0.005; flank r = −0.485, p = 0.01). Increased cerebral oxygen extraction was observed for the lowest three hematocrit quartiles (Q1 0.26 ± 0.08, p = 0.004; Q2 0.24 ± 0.09, p = 0.01; Q3 0.25 ± 0.09, p = 0.03; all compared with Q4 0.18 ± 0.10). Increased flank oxygen extraction occurred for the lowest two quartiles (Q1 0.36 ± 0.12, p < 0.001; Q2 0.35 ± 0.11, p < 0.001; compared with Q4 0.22 ± 0.13). Splanchnic oxygen extraction demonstrated no similar correlations.Conclusion Increases in tissue oxygen extraction may indicate early pathophysiologic responses to nascent anemia in premature neonates. PB - Thieme Medical Publishers DO - 10.1055/s-0038-1660458 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0038-1660458 ER -