ArticleEarly human development2020
Progressive anemia of prematurity is associated with a critical increase in cerebral oxygen extraction.
Article in Early human development, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- [Clinical practice guidelines for the diagnosis and treatment of anemia of prematurity (2025)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025Guideline
- Anemia and Red Blood Cell Transfusions, Cerebral Oxygenation, Brain Injury and Development, and Neurodevelopmental Outcome in Preterm Infants: A Systematic Review.Frontiers in pediatrics · 2021Pooled it
- Tissue Oxygenation Changes After Transfusion and Outcomes in Preterm Infants: A Secondary Near-Infrared Spectroscopy Study of the Transfusion of Prematures Randomized Clinical Trial (TOP NIRS).JAMA network open · 2023Trial
- Immune landscape in liver of neonatal mice with phlebotomy-induced anemia.Pediatric research · 2026Article
- Neonatal and 3-month cerebrovascular oxygenation, stability, and extraction in congenital heart disease versus control infants.Journal of clinical and translational science · 2025Article
- Altered cerebral oxygen extraction and metabolism in preterm neonates and the relationship to anemia: A noncontrast MRI study.Annals of the Child Neurology Society · 2024Article
- Stored RBC transfusions leads to the systemic inflammatory response syndrome in anemic murine neonates.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2024Article
- Early brain and abdominal oxygenation in extremely low birth weight infants.Pediatric research · 2022Article
- Regional tissue oxygenation and conventional indicators of red blood cell transfusion in anaemic preterm infants.EClinicalMedicine · 2022Article
- Three Physiological Components That Influence Regional Cerebral Tissue Oxygen Saturation.Frontiers in pediatrics · 2022Article
- Thresholds for blood transfusion in extremely preterm infants: A review of the latest evidence from two large clinical trials.Frontiers in pediatrics · 2022Review
- Anemia of prematurity: how low is too low?Journal of perinatology : official journal of the California Perinatal Association · 2021Review
- The hidden consequence of intraventricular hemorrhage: persistent cerebral desaturation after IVH in preterm infants.Pediatric research · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundElevated cerebral fractional tissue oxygen extraction (cFTOE) is an adaptation to anemia of prematurity (AOP). cFTOE ≥0.4 is associated with brain injury in infants ≤30 weeks. This longitudinal study sought to investigate the utility of cFTOE in the evaluation of AOP.
methodsInfants ≤30 weeks estimated gestational age (EGA) underwent weekly hemoglobin, cerebral saturation, and pulse oximetry recordings from the second through 36 weeks post-menstrual age (PMA). Recordings were excluded if they were under 1 h or if hemoglobin was not measured within 7 days of recording. Mean cFTOE was calculated for each recording. Statistical analysis used linear mixed-effects modeling and receiver operating characteristic analysis.
results144 recordings from 39 infants (mean EGA 27.6 ± 2.2 weeks, BW 1139 ± 286 g) were included of whom 39% (15/39) were transfused. The mean recording length was 2.8 ± 1.3 h. There was a significant negative correlation between hemoglobin and cFTOE (R = -0.423, p ≤.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 9.6 g/dL.
conclusionsAOP is associated with a critical increase in cFTOE that occurs at a significantly higher hemoglobin level than standard clinical thresholds for transfusion.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.