Abstract 1164 Poster Session IV, Tuesday, 5/4 (poster 227)

Background Hemoglobin concentration is a poor indicator of the adequacy of tissue oxygenation. Fractional oxygen extraction (FOE) represents the balance between oxygen delivery and consumption. FOE can be determined if the arterial (SaO2) and venous (SvO2) oxygen saturation are known: FOE = (SaO2-SvO2)/SaO2. SaO2 was measured by pulse oximetry; SvO2 was measured by near infrared spectroscopy with venous occlusion (Ped Res 1996; 39:1103-6).

Aim To determine whether PFOE can be used to determine the need for blood transfusion in stable preterm infants. We hypothesized that guidance by PFOE measurements would result in a reduction in the number of transfusions.

Methods Stable very low birthweight infants were randomized to transfusion according to: (a) conventional guidelines (maintain Hb > 14 g/dl if ventilated, maintain Hb > 12 g/dl if oxygen dependent or having surgery, maintain Hb > 8 g/dl if asymptomatic but reticulocyte count < 100 000); or (b) PFOE measurements (PFOE > 0.47 or clinical deterioration).

Results 74 infants were studied. (Table) Data are absolute numbers or median (range)

Table 1 No caption
Full size table

Conclusion There was no significant difference in the median number of transfusions (p=0.6), but 28 more transfusions were given to the infants in the Conventional Group compared with those in the PFOE Group.