Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Packed red blood cells transfusion in neonates: effect on FiO2 and PaO2/SaO2 ratio, and implications for neonatal saturation targeting

Abstract

Objective

To assess the effect of blood transfusions in neonates on partial pressure of oxygen in arterial blood (PaO2), arterial hemoglobin oxygen saturation (SaO2) and arterial hemoglobin oxygen saturation as measured by pulse oximetry (SpO2).

Study design

Retrospective study of neonates that received a first blood transfusion while having an indwelling arterial line. We compared PaO2, SaO2, SpO2, SaO2/PaO2 ratio and fraction of inspired oxygen (FiO2) 12 h before and after blood transfusion.

Results

Post-transfusion neonates had higher PaO2 and SaO2, had lower SaO2/PaO2 ratio, and received higher FiO2 with no change in SpO2.

Conclusions

Post-transfusion, neonates had lower hemoglobin oxygen affinity. They received higher FiO2 and had higher PaO2 at the same SpO2. We speculate that FiO2 was increased in order to maintain SpO2. Larger prospective trials are needed to confirm our findings.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Phillips HM, Holland BM, Jones JG, Abdel-Moiz AL, Turner TL, Wardrop CA. Definitive estimate of rate of hemoglobin switching: measurement of percent hemoglobin F in neonatal reticulocytes. Pediatr Res. 1988;23:595–7.

    Article  PubMed  CAS  Google Scholar 

  2. De Halleux V, Gagnon C, Bard H. Decreasing oxygen saturation in very early preterm newborn infants after transfusion. Arch Dis Child Fetal Neonatal Ed. 2003;88:F163.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Askie LM, Darlow BA, Davis PG, Finer N, Stenson B, Vento M et al. Effects of targeting lower versus higher arterial oxygen saturations on death or disability in preterm infants (Review). The Cochrane Collaboration 2017;4:CD011190.

    Google Scholar 

  4. Shiao SY. Effects of fetal hemoglobin on accurate measurements of oxygen saturation in neonates. J Perinat Neonatal Nurs. 2005;19:348–61.

    Article  PubMed  Google Scholar 

  5. James L, Greenough A, Naik S. The effect of blood transfusion on oxygenation in premature ventilated neonates. Eur J Pediatr. 1997;156:139–41.

    Article  PubMed  CAS  Google Scholar 

  6. Rashid N, Al-Sufayan F, Seshia MM, Baier RJ. Post transfusion lung injury in the neonatal population. J Perinatol. 2013;33:292–6.

    Article  PubMed  CAS  Google Scholar 

  7. Lakshminrusimha S, Manja V, Mathew B, Suresh GK. Oxygen targeting in preterm infants: a physiological interpretation. J Perinatol. 2015;35:8–15.

    Article  PubMed  CAS  Google Scholar 

  8. Shiao SY, Ou CN, Pierantoni H. The measurement of accurate fetal hemoglobin and related oxygen saturation by the hemoximeter. Clin Chim Acta. 2006;374:75–80.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Fang J Sorita A, Carey WA, Colby CE, Murad MH, Alahdab F Interventions To Prevent Retinopathy of Prematurity: A Meta-analysis. Pediatrics 2016;137. pii: e20153387. https://doi.org/10.1542/peds.2015-3387

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Itamar Nitzan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nitzan, I., Hammerman, C., Mimouni, F.B. et al. Packed red blood cells transfusion in neonates: effect on FiO2 and PaO2/SaO2 ratio, and implications for neonatal saturation targeting. J Perinatol 38, 693–695 (2018). https://doi.org/10.1038/s41372-018-0079-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-018-0079-x

Search

Quick links