Application of near-infrared spectroscopy in extremely and very low birth weight infants for red blood cells transfusion

Abstract

Near-infrared spectroscopy (NIRS), or cerebral oximetry, is a non-invasive method for assessing the oxidative status (saturation of hemoglobin with oxygen) mainly in the blood of cerebral venous vessels, which is increasingly used in clinical practice, in particular in neonatology. This method allows us to evaluate not only tissue perfusion, but also to determine the differences between the indicators of cerebral and peripheral oxygenation. Few studies have described improvements in tissue oxygenation indicators determined by NIRS after red blood cells transfusion in premature newborns. In our study we registered the oximetry indicators before and after red blood cells transfusion in extremely and very low birth weight infants (n = 55). This clinical study was approved by the Biomedical Research Ethics Committee (Protocol No. 19 dated 17 November 2016) and the Scientific Council of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of the Russian Federation (Protocol No. 19 dated 29 November 2016). Our study demonstrated a statistically significant increase in CrSO2 , SrSO2 , RrSO2 and SCOR and a decrease in C-FTOE, S-FTOE after a blood transfusion. The study also showed that a decrease in NIRS values (SCOR ≤ 0.76, C-FTOE ≥ 0.29, CrSO2 ≤ 64%, SrSO2 ≤ 54%, and RrSO2 ≤ 56%) can serve as an additional non-invasive measure of anemia and its progression; it helps detect a decrease in cerebral oxygenation at an early, preclinical stage of disease, and can also be used as an additional indicator of the need for red blood cell transfusions.