The effect of erythrocyte transfusion on oxygenation in preterm infants born before 32 weeks of gestation: an assessment using histogram analysis

Objective: The effect of erythrocyte transfusion on oxygenation in preterm neonates has been a subject of ongoing research. However, the short- and medium-term impact of transfusion on oxygen saturation in preterm infants remains unclear. This study aimed to evaluate the effect of erythrocyte transfusion on oxygenation in preterm infants born before 32 weeks of gestation using histogram analysis. Materials and Methods: This prospective observational study was conducted in the Neonatal Intensive Care Unit of Selçuk University Faculty of Medicine between January 2023 and December 2023. Preterm infants born before 32 weeks of gestation with stable clinical conditions and requiring erythrocyte transfusion were included in the study. Oxygen saturation histogram data of infants undergoing erythrocyte transfusion were analyzed at 24 hours before transfusion and at 24,48 and 72 hours after transfusion. In addition, pre- and post-transfusion hematocrit, hemoglobin, vital signs, respiratory support requirements, and prematurity-related complications were recorded. The collected data were analyzed using the SPSS software, and statistical comparisons between groups were performed. A p-value of <0.05 was considered statistically significant. Results: A total of 33 preterm infants were included in the study. Of the participants, 48.5% (n=16) were female, and 51.5% (n=17) were male. The mean gestational age was 29.4±2.1 weeks, and the mean birth weight was 1220.6±316.9 grams. When oxygen saturation histogram values before and after transfusion were examined, no statistically significant difference was found at 24, 48, and 72 hours post-transfusion (p>0.05). However, there was a trend towards an increase in oxygen saturation within the 86-90% range following transfusion. No significant changes were observed in hypoxemia and hyperoxemia durations, although a reduction in respiratory support requirements was noted in some infants. PEEP values showed a slight decrease at 48 and 72 hours post-transfusion, but this was not statistically significant (p>0.05). In terms of vital signs, heart rate and respiratory rate exhibited a decreasing trend after transfusion. Premature retinopathy (ROP) was detected in 36.4% (n=12) of cases, while bronchopulmonary dysplasia (BPD) was found in 12.1% (n=4). Conclusion: Based on the findings, no significant changes were observed in oxygen saturation histogram values following erythrocyte transfusion, but oxygen saturation tended to remain within the normoxemic range. Transfusion did not significantly alter PEEP, PIP, FiO₂, or vital parameters; however, it was associated with a reduction in respiratory support needs in some infants. Further studies are needed to assess the short-term effects of erythrocyte transfusion on oxygenation parameters in preterm neonates. Keywords: Preterm, erythrocyte transfusion, oxygen saturation, histogram, neonatal intensive care.