ArticlePediatric research2022
Early brain and abdominal oxygenation in extremely low birth weight infants.
Article in Pediatric research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Preliminary exploration of tissue oxygen saturation index using near-infrared spectroscopy in two infants of neonatal catheter-associated venous thrombosis.BMC pediatrics · 2026Article
- Comparison of Near-Infrared Spectroscopy and Traditional Parameters for Monitoring Neonates with Aortic Coarctation.Pediatric cardiology · 2026Article
- Patient Blood Management in Pediatric Patients: Current Strategies and Future PerspectivesTurkish journal of haematology : official journal of Turkish Society of Haematology · 2025Review
- [Regional mesenteric oxygen saturation during blood transfusion in premature neonates].Revista medica del Instituto Mexicano del Seguro Social · 2025Observational
- 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
- Review
- Effects of the feeding protocol during blood transfusion on splanchnic tissue oxygenation and complications in very premature infants.Frontiers in nutrition · 2024Article
- Preterm Infants off Positive Pressure Respiratory Support Have a Higher Incidence of Occult Cerebral Hypoxia.The Journal of pediatrics · 2023Observational
- Red Blood Cell Transfusion Thresholds for Anemia of Prematurity.NeoReviews · 2023Review
- Cross-sectional association between red blood cell distribution width and regional cerebral tissue oxygen saturation in preterm infants in the first 14 days after birth.Frontiers in pediatrics · 2023Article
- Optimal neuromonitoring techniques in neonates with hypoxic ischemic encephalopathy.Frontiers in pediatrics · 2023Review
- A phase-II clinical trial of targeted cerebral near infrared spectroscopy using standardized treatment guidelines to improve brain oxygenation in preterm infants (BOx-II): A study protocol.Contemporary clinical trials · 2022Article
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Authors and funding
27 authors at 19 institutions in 1 country.
Funding
Abstract
backgroundExtremely low birth weight (ELBW) infants are at risk for end-organ hypoxia and ischemia. Regional tissue oxygenation of the brain and gut as monitored with near-infrared spectroscopy (NIRS) may change with postnatal age, but normal ranges are not well defined.
methodsA prospective study of ELBW preterm infants utilized NIRS monitoring to assess changes in cerebral and mesenteric saturation (Csat and Msat) over the first week after birth. This secondary study of a multicenter trial comparing hemoglobin transfusion thresholds assessed cerebral and mesenteric fractional tissue oxygen extraction (cFTOE and mFTOE) and relationships with perinatal variables.
resultsIn 124 infants, both Csat and Msat declined over the first week, with a corresponding increase in oxygen extraction. With lower gestational age, lower birth weight, and 5-min Apgar score ≤5, there was a greater increase in oxygen extraction in the brain compared to the gut. Infants managed with a lower hemoglobin transfusion threshold receiving ≥2 transfusions in the first week had the lowest Csat and highest cFTOE (p < 0.001).
conclusionBrain oxygen extraction preferentially increased in more immature and anemic preterm infants. NIRS monitoring may enhance understanding of cerebral and mesenteric oxygenation patterns and inform future protective strategies in the preterm ELBW population. IMPACT: Simultaneous monitoring of cerebral and mesenteric tissue saturation demonstrates the balance of oxygenation between preterm brain and gut and may inform protective strategies. Over the first week, oxygen saturation of the brain and gut declines as oxygen extraction increases. A low hemoglobin transfusion threshold is associated with lower cerebral saturation and higher cerebral oxygen extraction compared to a high hemoglobin transfusion threshold, although this did not translate into clinically relevant differences in the TOP trial primary outcome. Greater oxygen extraction by the brain compared to the gut occurs with lower gestational age, lower birth weight, and 5-min Apgar score ≤5.
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