Fetal haemoglobin and oxygen requirement in preterm infants : an observational study
Ulinder, Tommy LU ; Hellström, William ; Gadsbøll, Christian LU ; Nilsson, Linda LU ; Gebka, Margareta LU ; Robertz, Gustav ; Bruschettini, Matteo LU
; Hellstrom, Ann
and Ley, David
LU
(2024)
In Archives of disease in childhood. Fetal and neonatal edition
- Abstract
OBJECTIVE: To investigate the relationship between the fraction of fetal haemoglobin (HbF(%)) and oxygen requirement as determined by the fraction of inspired oxygen (FiO2) and alveolar-arterial gradient (A-a gradient). Increased alveolar exposure to oxygen may explain the association between decreased HbF(%) and the development of bronchopulmonary dysplasia (BPD).
DESIGN: Longitudinal, retrospective, observational study.
SETTING: Tertiary-level neonatal intensive care unit, referral centre for southern Sweden.
PATIENTS: Four hundred forty very preterm infants born before gestational week 30, 2009-2015.
INTERVENTION: Regular clinical practice.
MAIN OUTCOME MEASURES: The FiO2 and A-a gradient were determined... (More)
OBJECTIVE: To investigate the relationship between the fraction of fetal haemoglobin (HbF(%)) and oxygen requirement as determined by the fraction of inspired oxygen (FiO2) and alveolar-arterial gradient (A-a gradient). Increased alveolar exposure to oxygen may explain the association between decreased HbF(%) and the development of bronchopulmonary dysplasia (BPD).
DESIGN: Longitudinal, retrospective, observational study.
SETTING: Tertiary-level neonatal intensive care unit, referral centre for southern Sweden.
PATIENTS: Four hundred forty very preterm infants born before gestational week 30, 2009-2015.
INTERVENTION: Regular clinical practice.
MAIN OUTCOME MEASURES: The FiO2 and A-a gradient were determined at the time-point of 10 015 arterial blood gas analyses obtained during postnatal days 1-7. The relationship between HbF(%) and FiO2 and A-a gradient and the modifying influence of other factors affecting haemoglobin oxygen affinity were evaluated.
RESULTS: We found a significant relationship between a low fraction of HbF and an increase in FiO2 and A-a gradient, respectively. These relationships remained significant after adjusting for pH, pCO2, postnatal age, gestational age and sex.
CONCLUSION: These high-resolution data show that decreased HbF(%) during the first postnatal week is associated with increased FiO2 and A-a gradient in very preterm infants. Increased alveolar exposure to oxygen and resulting oxidative stress may, at least partly, explain the previously reported associations between decreased HbF, blood transfusions and the development of BPD in preterm infants.
(Less)
- author
- Ulinder, Tommy
LU
; Hellström, William
; Gadsbøll, Christian
LU
; Nilsson, Linda
LU
; Gebka, Margareta
LU
; Robertz, Gustav
; Bruschettini, Matteo
LU
; Hellstrom, Ann
and Ley, David
LU
- organization
- publishing date
- 2024-09-25
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Archives of disease in childhood. Fetal and neonatal edition
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:39322316
- ISSN
- 1359-2998
- DOI
- 10.1136/archdischild-2024-327411
- language
- English
- LU publication?
- yes
- additional info
- © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
- id
- fedff68d-4d9b-409a-8c35-fa2b23487741
- date added to LUP
- 2024-09-26 16:19:16
- date last changed
- 2024-09-26 16:19:16
@article{fedff68d-4d9b-409a-8c35-fa2b23487741,
abstract = {{<p>OBJECTIVE: To investigate the relationship between the fraction of fetal haemoglobin (HbF(%)) and oxygen requirement as determined by the fraction of inspired oxygen (FiO2) and alveolar-arterial gradient (A-a gradient). Increased alveolar exposure to oxygen may explain the association between decreased HbF(%) and the development of bronchopulmonary dysplasia (BPD).</p><p>DESIGN: Longitudinal, retrospective, observational study.</p><p>SETTING: Tertiary-level neonatal intensive care unit, referral centre for southern Sweden.</p><p>PATIENTS: Four hundred forty very preterm infants born before gestational week 30, 2009-2015.</p><p>INTERVENTION: Regular clinical practice.</p><p>MAIN OUTCOME MEASURES: The FiO2 and A-a gradient were determined at the time-point of 10 015 arterial blood gas analyses obtained during postnatal days 1-7. The relationship between HbF(%) and FiO2 and A-a gradient and the modifying influence of other factors affecting haemoglobin oxygen affinity were evaluated.</p><p>RESULTS: We found a significant relationship between a low fraction of HbF and an increase in FiO2 and A-a gradient, respectively. These relationships remained significant after adjusting for pH, pCO2, postnatal age, gestational age and sex.</p><p>CONCLUSION: These high-resolution data show that decreased HbF(%) during the first postnatal week is associated with increased FiO2 and A-a gradient in very preterm infants. Increased alveolar exposure to oxygen and resulting oxidative stress may, at least partly, explain the previously reported associations between decreased HbF, blood transfusions and the development of BPD in preterm infants.</p>}},
author = {{Ulinder, Tommy and Hellström, William and Gadsbøll, Christian and Nilsson, Linda and Gebka, Margareta and Robertz, Gustav and Bruschettini, Matteo and Hellstrom, Ann and Ley, David}},
issn = {{1359-2998}},
language = {{eng}},
month = {{09}},
publisher = {{BMJ Publishing Group}},
series = {{Archives of disease in childhood. Fetal and neonatal edition}},
title = {{Fetal haemoglobin and oxygen requirement in preterm infants : an observational study}},
url = {{http://dx.doi.org/10.1136/archdischild-2024-327411}},
doi = {{10.1136/archdischild-2024-327411}},
year = {{2024}},
}