Elevated brain oxygen extraction fraction in preterm newborns with anemia measured using noninvasive MRI. (December 2018)

• Record Type: Journal Article
• Authors: Morris, Emily; Juttukonda, Meher; Lee, Chelsea; Patel, Niral; Pruthi, Sumit; Donahue, Manus; Jordan, Lori
• Is Part Of: Journal of perinatology. Volume 38:Number 12(2018)
• Page Start: 1636
• Page End: 1643
• Publication Date: 2018-12
• Subjects: Perinatology -- Periodicals; 618.32005
• DOI: 10.1038/s41372-018-0229-1
• Languages: English
• ISSNs: 0743-8346

Abstract

Abstract Objective To test the hypothesis that cerebral oxygen extraction fraction (OEF) is elevated and inversely related to hematocrit level in anemic former very-low-birth-weight infants near term. Study design Prospective study of non-sedated preterm infants (post-menstrual age = 36 ± 2 weeks) over a range of hematocrits (0.23–0.49). Anatomical (T 1 -W, T 2 -W, and diffusion-weighted), cerebral blood flow (CBF), and OEF 3-T MRI were utilized. Statistical analysis included Spearman's rank-order correlation testing between study variables and intraclass correlation coefficients (ICC) calculated between consecutively acquired OEF scans. Results Consecutive OEF measurements showed moderate-to-good agreement (ICC = 0.71; 95% CI = 0.40–0.87). OEF increased with worsening anemia (ρ = −0.58;p = 0.005), and OEF and basal ganglia CBF were positively correlated (ρ = 0.49;p = 0.023). Conclusion Noninvasive OEF MRI has moderate-to-good repeatability in non-sedated former preterm infants nearing term-equivalent age. Strong correlation of elevated OEF with anemia suggests hemodynamic compensation for anemia and could establish OEF as a useful biomarker of transfusion threshold for preterm infants.