Evidence map›Paper›PMID 35857790›Full record

ArticlePloS one2022

Hierarchical improvement of regional tissue oxygenation after packed red blood cell transfusion.

Kiran Kumar Balegar V, Madhuka Jayawardhana, Andrew J Martin, Philip de Chazal, Ralph Kay Heinrich Nanan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Kiran Kumar Balegar VDepartment of Neonatology, Nepean Hospital, Sydney Medical School Nepean, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0003-3952-5536
Madhuka JayawardhanaSchool of Electrical Engineering and the Charles Perkins Center, The University of Sydney, Sydney, NSW, Australia.
Andrew J MartinNHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.
Philip de ChazalSchool of Biomedical Engineering and the Charles Perkins Center, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-2091-207X
Ralph Kay Heinrich NananSydney Medical School and Charles Perkins Center Nepean, The University of Sydney, Sydney, NSW, Australia.
The University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is well established that counter-regulation to hypoxia follows a hierarchical pattern, with brain-sparing in preference to peripheral tissues. In contrast, it is unknown if the same hierarchical sequence applies to recovery from hypoxia after correction of anemia with packed red blood cell transfusion (PRBCT).

objectiveTo understand the chronology of cerebral and splanchnic tissue oxygenation resulting after correction of anemia by PRBCT in preterm infants using near-infrared spectroscopy (NIRS).

designProspective cohort study.

settingNeonatal intensive care. PATIENTS INCLUDED: Haemodynamically stable infants: <32 weeks gestation, <37weeks postmenstrual age, <1500 grams birth weight; and ≥120 mL/kg/day feeds tolerated.

interventionPRBCT at 15 mL/Kg over 4 hours.

main outcome measuresTransfusion-associated changes were determined by comparing the 4-hour mean pre-transfusion cerebral and splanchnic fractional tissue oxygen extraction (FTOEc0; FTOEs0) with hourly means during (FTOEc1-4; FTOEs1-4) and for 24 hours after PRBCT completion (FTOEc5-28; FTOEs5-28).

resultsOf 30 enrolled infants, 14[46.7%] male; median[IQR] birth weight, 923[655-1064]g; gestation, 26.4[25.5-28.1]weeks; enrolment weight, 1549[1113-1882]g; and postmenstrual age, 33.6[32.4-35]weeks, 1 infant was excluded because of corrupted NIRS data. FTOEc significantly decreased during and for 24 hours after PRBCT (p < 0.001), indicating prompt improvement in cerebral oxygenation. In contrast, FTOEs showed no significant changes during and after PRBCT (p>0.05), indicating failure of improvement in splanchnic oxygenation.

conclusionImprovement in regional oxygenation after PRBCT follows the same hierarchical pattern with a prompt improvement of cerebral but not splanchnic tissue oxygenation. We hypothesise that this hierarchical recovery may indicate continued splanchnic hypoxia in the immediate post-transfusion period and vulnerability to transfusion-associated necrotizing enterocolitis (TANEC). Our study provides a possible mechanistic underpinning for TANEC and warrants future randomised controlled studies to stratify its prevention.

Indexed as

AnemiaEnterocolitis, NecrotizingAdultBirth WeightErythrocyte TransfusionFemaleHumansHypoxiaInfant, NewbornInfant, PrematureMaleOxygenProspective StudiesOxygen

Identifiers

PMID35857790
PMCPMC9299358
OpenAlexW4286210176

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.