Red blood cell transfusions (RBCTs) have been associated with necrotising enterocolitis (NEC) in preterm infants (PTIs). The objective of this report is to evaluate the use of regional cerebral (cRSO2) and splanchnic (sRSO2) tissue oximetry measured using near infrared (NIR) spectroscopy as biomarkers to evaluate the association between RBCT and NEC in a secondary analysis of a hypothesis-generating Phase I exploratory study of biomarker development. cRSO2 and sRSO2 were monitored in PTIs receiving RBCTs. Three time periods were defined: pre-RBCT (12 h prior to RBCT), during RBCT and post-RBCT (24 h after RBCT). Three groups were defined: absence of NEC within ±7 days of index RBCT (Group 1); NEC within 7 days prior (Group 2) and within 7 days after RBCT (Group 3). Mean hourly sRSO2 and cRSO2 were compared between groups across RBCT periods using the mixed effect method. Neonatal postnatal morbidities and treatments were included as covariates. Fifty-seven infants (median gestational age 27 weeks) received 147 RBCTs (Group 1 = 120, Group 2 = 19, and Group 3 = 8) during NIR spectroscopy monitoring. In the adjusted analysis, there was a significant change in sRSO2 during the course of RBCT (p = 0.0405) with significant interaction with group (p < 0.0001) such that in Groups 1 and 2, sRSO2increased over RBCT periods, whereas in Group 3, sRSO2declined over RBCT periods. cRSO2increased during the course of the RBCT (p < 0.0001) with significant interaction with group (p = 0.0258). cRSO2 and sRSO2 increased significantly following RBCT in infants without NEC or NEC diagnosed prior to RBCT. Post-RBCT sRSO2 decreased in infants who were subsequently diagnosed with NEC in this exploratory secondary analysis of a Phase I Biomarker study. sRSO2 response may potentially be a biomarker to identify infants who are likely to develop NEC post-RBCT that needs to be validated in larger prospective “hypothesis-testing” randomised controlled trials.
WhyteR. and KirpalaniH., “Low versus high haemoglobin concentration threshold for blood transfusion for preventing morbidity and mortality in very low birth weight infants”, Cochrane Database Syst RevCD000512 (2011). doi: http://dx.doi.org/10.1002/14651858.CD000512.pub2
2.
MohamedA. and ShahP.S., “Transfusion associated necrotizing enterocolitis: A meta-analysis of observational data”, Pediatrics129, 529 (2012). doi: http://dx.doi.org/10.1542/peds.2011-2872
3.
JosephsonC.D.WesolowskiA.BaoG.Sola-VisnerM.C.DudellG.CastillejoM.I.ShazB.H.EasleyK.A.HillyerC.D. and MaheshwariA., “Do red cell transfusions increase the risk of necrotizing enterocolitis in premature infants?”, J Pediatr157, 972 (2010). doi: http://dx.doi.org/10.1016/j.jpeds.2010.05.054
4.
BakS.Y.LeeS.ParkJ.H.ParkK.H. and JeonJ.H., “Analysis of the association between necrotizing enterocolitis and transfusion of red blood cell in very low birth weight preterm infants”, Korean J Pediatr56, 112 (2013). doi: http://dx.doi.org/10.3345/kjp.2013.56.3.112
5.
StritzkeA.I.SmythJ.SynnesA.LeeS.K. and ShahP.S., “Transfusion-associated necrotising enterocolitis in neonates”, Arch Dis Child Fetal Neonatal Ed98, F10 (2013). doi: http://dx.doi.org/10.1136/fetalneonatal-2011-301282
6.
SinghR.VisintainerP.F.FrantzI.D.3rdShahB.L.MeyerK.M.FavilaS.A.ThomasM.S. and KentD.M., “Association of necrotizing enterocolitis with anemia and packed red blood cell transfusions in preterm infants”, J Perinatol31, 176 (2011). doi: http://dx.doi.org/10.1038/jp.2010.145
7.
MallyP.GolombekS.G.MishraR.NigamS.MohandasK.DepalhmaH. and LaGammaE.F., “Association of necrotizing enterocolitis with elective packed red blood cell transfusions in stable, growing, premature neonates”, Am J Perinatol23, 451 (2006). doi: http://dx.doi.org/10.1055/s-2006-951300
8.
BlauJ.CaloJ.M.DozorD.SuttonM.AlpanG. and La GammaE.F., “Transfusion-related acute gut injury: Necrotizing enterocolitis in very low birth weight neonates after packed red blood cell transfusion”, J Pediatr158, 403 (2011). doi: http://dx.doi.org/10.1016/j.jpeds.2010.09.015
9.
PaulD.A.MackleyA.NovitskyA.ZhaoY.BrooksA. and LockeR.G., “Increased odds of necrotizing enterocolitis after transfusion of red blood cells in premature infants”, Pediatrics127, 635 (2011). doi: http://dx.doi.org/10.1542/peds.2010-3178
10.
El-DibM.NarangS.LeeE.MassaroA.N. and AlyH., “Red blood cell transfusion, feeding and necrotizing enterocolitis in preterm infants”, J Perinatol31, 183 (2011). doi: http://dx.doi.org/10.1038/jp.2010.157
11.
BednarekF.J.WeisbergerS.RichardsonD.K.FrantzI.D.3rdShahB. and RubinL.P., “Variations in blood transfusions among newborn intensive care units. Snap II Study Group”, J Pediatr133, 601 (1998). doi: http://dx.doi.org/a93289
12.
KirpalaniH.WhyteR.K.AndersenC.AsztalosE.V.HeddleN.BlajchmanM.A.PeliowskiA.RiosA.LaCorteM.ConnellyR.BarringtonK. and RobertsR.S., “The premature infants in need of transfusion (PINT) study: A randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants”, J Pediatr149, 301 (2006). doi: http://dx.doi.org/S0022-3476(06)00444-6
13.
La GammaE.F. and BlauJ., “Transfusion-related acute gut injury: Feeding, flora, flow, and barrier defense”, Semin Perinatol36, 294 (2012). doi: http://dx.doi.org/10.1053/j.semperi.2012.04.011
14.
DemirelG.CelikI.H.AksoyH.T.ErdeveO.OguzS.S.UrasN. and DilmenU., “Transfusion-associated necrotising enterocolitis in very low birth weight premature infants”, Transfus Med22, 332 (2012). doi: http://dx.doi.org/10.1111/j.1365-3148.2012.01170.x
15.
KirpalaniH. and ZupancicJ.A., “Do transfusions cause necrotizing enterocolitis? The complementary role of randomized trials and observational studies”, Semin Perinatol36, 269 (2012). doi: http://dx.doi.org/10.1053/j.semperi.2012.04.007
16.
ChristensenR.D.LambertD.K.HenryE.WiedmeierS.E.SnowG.L.BaerV.L.GerdayE.IlstrupS. and PysherT.J., “Is ‘transfusion-associated necrotizing enterocolitis’ an authentic pathogenic entity?”, Transfusion50, 1106 (2010). doi: http://dx.doi.org/10.1111/j.1537-2995.2009.02542.x
17.
ElabiadM.T.HarsonoM.TalatiA.J. and DhanireddyR., “Effect of Birth Weight on the Association between Necrotising Enterocolitis and Red Blood Cell Transfusions in >=1500 G Infants”, BMJ open3, e003823 (2013). doi: http://dx.doi.org/10.1136/bmjo-pen-2013-003823
18.
ValievaO.A.StrandjordT.P.MayockD.E. and JuulS.E., “Effects of transfusions in extremely low birth weight infants: A retrospective study”, J Pediatr155, 331 (2009). doi: http://dx.doi.org/10.1016/j.jpeds.2009.02.026
19.
McGradyG.A.RettingP.J.IstreG.R.JasonJ.M.HolmanR.C. and EvatiB.L., “An outbreak of necrotizing enterocolitis: Association with transfusions of packed red blood cells”, Am J Epidemiol126, 1165 (1987).
AminS.C.RemonJ.I.SubbaraoG.C. and MaheshwariA., “Association between red cell transfusions and necrotizing enterocolitis”, J Matern Fetal Neonatal Med25, 85 (2012). doi: http://dx.doi.org/10.3109/14767058.2012.715465
22.
LawrenceS.M.NandyalR.HallfordG.AndersonM. and HartN., “Changes in hematocrit following a blood transfusion does not influence the risk for necrotizing enterocolitis: A case-control study”, J Neonatal Perinatal Med7, 21 (2014). doi: http://dx.doi.org/10.3233/NPM-1475513
23.
SharmaR.KraemerD.F.TorrazzaR.M.MaiV.NeuJ.ShusterJ.J. and HudakM.L., “Packed red blood cell transfusion is not associated with increased risk of necrotizing enterocolitis in premature infants”, J Perinatol (2014). doi: http://dx.doi.org/10.1038/jp.2014.59
24.
BanerjeeJ. and AladangadyN., “Biomarkers to decide red blood cell transfusion in newborn infants”, Transfusion54, 2574 (2014). doi: http://dx.doi.org/10.1111/trf.12670
25.
CortezJ.GuptaM.AmaramA.PizzinoJ.SawhneyM. and SoodB.G., “Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm neonates”, J Matern Fetal Neonatal Med24, 574 (2011). doi: http://dx.doi.org/10.3109/14767058.2010.511335
26.
WardleS.P.GarrR.YoxallC.W. and WeindlingA.M., “A pilot randomised controlled trial of peripheral fractional oxygen extraction to guide blood transfusions in preterm infants”, Arch Dis Child Fetal Neonatal Ed86, F22 (2002). doi: http://dx.doi.org/10.1136/fn.86.1.F22
27.
BaileyS.M.Hendricks-MunozK.D.WellsJ.T. and MallyP., “Packed red blood cell transfusion increases regional cerebral and splanchnic tissue oxygen saturation in anemic symptomatic preterm infants”, Am J Perinatol27, 445 (2010). doi: http://dx.doi.org/10.1055/s-0030-1247598
28.
BaileyS.M.Hendricks-MunozK.D. and MallyP., “Splanchnic–cerebral oxygenation ratio as a marker of preterm infant blood transfusion needs”, Transfusion52, 252 (2012). doi: http://dx.doi.org/10.1111/j.1537-2995.2011.03263.x
29.
OhS.YoungC.GravensteinN.IslamS. and NeuJ., “Monitoring technologies in the neonatal intensive care unit: Implications for the detection of necrotizing enterocolitis”, J Perinatol30, 701 (2010). doi: http://dx.doi.org/10.1038/jp.2010.9
30.
SeidelD.BlaserA.GebauerC.PulzerF.ThomeU. and KnupferM., “Changes in regional tissue oxygenation saturation and desaturations after red blood cell transfusion in preterm infants”, J Perinatol33, 282 (2013). doi: http://dx.doi.org/10.1038/jp.2012.108
31.
DaniC.PratesiS.FontanelliG.BarpJ. and BertiniG., “Blood transfusions increase cerebral, splanchnic, and renal oxygenation in anemic preterm infants”, Transfusion50, 1220 (2010). doi: http://dx.doi.org/10.1111/j.1537-2995.2009.02575.x
32.
van HoftenJ.C.VerhagenE.A.KeatingP.ter HorstH.J. and BosA.F., “Cerebral tissue oxygen saturation and extraction in preterm infants before and after blood transfusion”, Arch Dis Child Fetal Neonatal Ed95, F352 (2010). doi: http://dx.doi.org/10.1136/adc.2009.163592
33.
MarinT.MooreJ.KosmetatosN.RobackJ.D.WeissP.HigginsM.McCauleyL.StricklandO.L. and JosephsonC.D., “Red blood cell transfusion-related necrotizing enterocolitis in very-low-birthweight infants: A near-infrared spectroscopy investigation”, Transfusion53, 2650 (2013). doi: http://dx.doi.org/10.1111/trf.12158
LouisD.MukhopadhyayK.SodhiK.S.JainV. and KumarP., “Superior mesenteric artery doppler is poor at predicting feed intolerance and nec in preterm small for gestational age neonates”, J Matern Fetal Neonatal Med26, 1855 (2013). doi: http://dx.doi.org/10.3109/14767058.2013.799649
36.
KliegmanR.M. and WalshM.C., “Neonatal necrotizing enterocolitis: Pathogenesis, classification, and spectrum of illness”, Curr Probl Pediatr17, 213 (1987).
37.
WalshM.C. and KliegmanR.M., “Necrotizing enterocolitis: Treatment based on staging criteria”, Pediatr Clin North Am33, 179 (1986).
38.
GarnerR.S. and BurchfieldD.J., “Treatment of presumed hypotension in very low birthweight neonates: Effects on regional cerebral oxygenation”, Arch Dis Child Fetal Neonatal Ed98, F117 (2013). doi: http://dx.doi.org/10.1136/archdischild-2011-301488
39.
GarnerR.S.MillerC. and BurchfieldD.J., “Prophylactic indomethacin infusion increases fractional cerebral oxygen extraction in elbw neonates”, J Perinatol32, 695 (2012). doi: http://dx.doi.org/10.1038/jp.2011.175
40.
KidsonC. and DavidsonM., Near Infrared Spectroscopy (NIRS) User Guide, Ed by KidsonC. and DavidsonM.PICU Royal Hospital for Sick Children, Yorkhill, UK (2014).
41.
ShannonK.M.KeithJ.F.3rdMentzerW.C.EhrenkranzR.A.BrownM.S.WidnessJ.A.GleasonC.A.BifanoE.M.MillardD.D.DavisC.B., “Recombinant human erythropoietin stimulates erythropoiesis and reduces erythrocyte transfusions in very low birth weight preterm infants”, Pediatrics95, 1 (1995).
42.
FairchildK.D. and O'SheaT.M., “Heart rate characteristics: Physiomarkers for detection of late-onset neonatal sepsis”, Clin Perinatol37, 581 (2010). doi: http://dx.doi.org/10.1016/j.clp.2010.06.002
43.
BatesonT.F. and SchwartzJ., “Selection bias and confounding in case-crossover analyses of environmental time-series data”, Epidemiology12, 654 (2001).
44.
ArmstrongB. and GasparriniA., “Time series analysis for biomedical data,” in Time Series Regression Analysis, vol. 2014. Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK (2014).
45.
BhaskaranK.GasparriniA.HajatS.SmeethL. and ArmstrongB., “Time series regression studies in environmental epidemiology”, Int J Epidemiol42, 1187 (2013). doi: http://dx.doi.org/10.1093/ije/dyt092
46.
LuY. and ZegerS.L., “On the equivalence of case-crossover and time series methods in environmental epidemiology”, Biostatistics8, 337 (2007). doi: http://dx.doi.org/10.1093/biostatistics/kxl013
47.
LuY.SymonsJ.M.GeyhA.S. and ZegerS.L., “An approach to checking case-crossover analyses based on equivalence with time-series methods”, Epidemiology19, 169 (2008). doi: http://dx.doi.org/10.1097/EDE.0b013e3181632c24
48.
MaclureM., “The case-crossover design: A method for studying transient effects on the risk of acute events”, Am J Epidemiol133, 144 (1991).
49.
WagnerA.K.SoumeraiS.B.ZhangF. and Ross-DegnanD., “Segmented regression analysis of interrupted time series studies in medication use research”, J Clin Pharm Ther27, 299 (2002). doi: http://dx.doi.org/430
50.
SandalG.OguzS.S.ErdeveO.AkarM.UrasN. and DilmenU., “Assessment of red blood cell transfusion and transfusion duration on cerebral and mesenteric oxygenation using near-infrared spectroscopy in preterm infants with symptomatic anemia”, Transfusion54, 1100 (2014). doi: http://dx.doi.org/10.1111/trf.12359
51.
LiaoS.M.RaoR. and MathurA.M., “Head position change is not associated with acute changes in bilateral cerebral oxygenation in stable preterm infants during the first 3 days of life”, Am J Perinatol (2014). doi: http://dx.doi.org/10.1055/s-0034-1390348
52.
PellicerA.GreisenG.BendersM.ClarisO.DempseyE.FumagalliM.GluudC.HagmannC.Hellstrom-WestasL.Hyttel-SorensenS.LemmersP.NaulaersG.PichlerG.RollC.van BelF.van OeverenW.SkoogM.WolfM. and AustinT., “The Safeboosc Phase II randomised clinical trial: A treatment guideline for targeted near-infrared-derived cerebral tissue oxygenation versus standard treatment in extremely preterm infants”, Neonatology104, 171 (2013). doi: http://dx.doi.org/10.1159/000351346
53.
Hyttel-SorensenS.AustinT.van BelF.BendersM.ClarisO.DempseyE.M.FumagalliM.GluudC.HagmannC.Hellstrom-WestasL.LemmersP.NaulaersG.van OeverenW.PellicerA.PichlerG.RollC.StoyL.S.WolfM. and GreisenG., “Clinical use of cerebral oximetry in extremely preterm infants is feasible”, Dan Med J60, A4533 (2013). doi: http://dx.doi.org/A4533
54.
DemirelG.OguzS.S.CelikI.H.ErdeveO. and DilmenU., “Cerebral and mesenteric tissue oxygenation by positional changes in very low birth weight premature infants”, Early Hum Dev88, 409 (2012). doi: http://dx.doi.org/10.1016/j.earlhumdev.2011.10.005
55.
ChangI.L.Van MeursK.P.StevensonD.K. and ChockV.Y., “Near-infrared spectroscopy monitoring of regional oxygenation during packed red blood cell transfusions in preterm infants”, E-PAS 4521.286 (2011).
56.
BonestrooH.J.LemmersP.M.BaertsW. and van BelF., “Effect of antihypotensive treatment on cerebral oxygenation of preterm infants without PDA”, Pediatrics128, e1502 (2011). doi: http://dx.doi.org/10.1542/peds.2010-3791
57.
JobsisF.F., “Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters”, Science198, 1264 (1977).
58.
WolfbergA.J. and du PlessisA.J., “Near-infrared spectroscopy in the fetus and neonate”, Clin Perinatol33, 707 (2006). doi: http://dx.doi.org/S0095-5108(06)00055-8
59.
van BelF.LemmersP. and NaulaersG., “Monitoring neonatal regional cerebral oxygen saturation in clinical practice: Value and pitfalls”, Neonatology94, 237 (2008). doi: http://dx.doi.org/000151642
60.
TortorielloT.A.StayerS.A.MottA.R.McKenzieE.D.FraserC.D.AndropoulosD.B. and ChangA.C., “A non-invasive estimation of mixed venous oxygen saturation using near-infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients”, Paediatr Anaesth15, 495 (2005). doi: http://dx.doi.org/PAN1488
61.
GhoshA.ElwellC. and SmithM., “Review article: Cerebral near-infrared spectroscopy in adults: A work in progress”, Anesth Analg115, 1373 (2012). doi: http://dx.doi.org/10.1213/ANE.0b013e31826dd6a6
62.
TellerJ.SchwendenerK.WolfM.KeelM.BucherH.U.FanconiS. and BaenzigerO., “Continuous monitoring of liver oxygenation with near infrared spectroscopy during naso-gastric tube feeding in neonates”, Schweiz Med Wochenschr130, 652 (2000).
63.
ThompsonA.BenniP.SeyhanS. and EhrenkranzR., “Meconium and transitional stools may cause interference with near-infrared spectroscopy measurements of intestinal oxygen saturation in preterm infants”, Adv Exp Med Biol765, 287 (2013). doi: http://dx.doi.org/10.1007/978-1-4614-4989-8_40
64.
VarelaJ.E.CohnS.M.GiannottiG.D.DolichM.O.RamonH.WisebergJ.A. and McKenneyM., “Near-infrared spectroscopy reflects changes in mesenteric and systemic perfusion during abdominal compartment syndrome”, Surgery129, 363 (2001). doi: http://dx.doi.org/S0039-6060(01)89386-7
65.
PetrosA.J.HeysR.TaskerR.C.FortuneP.M.RobertsI. and KielyE., “Near infrared spectroscopy can detect changes in splanchnic oxygen delivery in neonates during apnoeic episodes”, Eur J Pediatr158, 173 (1999).
66.
MeierS.D.EbleB.K.StapletonG.E.MoralesD.L.ChangA.C. and AndropoulosD.B., “Mesenteric oxyhemoglobin desaturation improves with patent ductus arteriosus ligation”, J Perinatol26, 562 (2006). doi: http://dx.doi.org/7211559
67.
DaveV.BrionL.P.CampbellD.E.ScheinerM.RaabC. and NafdayS.M., “Splanchnic tissue oxygenation, but not brain tissue oxygenation, increases after feeds in stable preterm neonates tolerating full bolus orogastric feeding”, J Perinatol29, 213 (2009). doi: http://dx.doi.org/jp2008189
68.
FortuneP.M.WagstaffM. and PetrosA.J., “Cerebrosplanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischaemia in neonates”, Intensive Care Med27, 1401 (2001). doi: http://dx.doi.org/10.1007/s001340100994
69.
StapletonG.E.EbleB.K.DickersonH.A.AndropoulosD.B. and ChangA.C., “Mesenteric oxygen desaturation in an infant with congenital heart disease and necrotizing enterocolitis”, Tex Heart Inst J34, 442 (2007).
70.
McNeillS.GatenbyJ.C.McElroyS. and EngelhardtB., “Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants”, J Perinatol31, 51 (2011). doi: http://dx.doi.org/10.1038/jp.2010.71
71.
BaileyS.M.Hendricks-MunozK.D. and MallyP., “Cerebral, renal, and splanchnic tissue oxygen saturation values in healthy term newborns”, Am J Perinatol31, 339 (2014). doi: http://dx.doi.org/10.1055/s-0033-1349894
72.
KaufmanJ.AlmodovarM.C.ZukJ. and FriesenR.H., “Correlation of abdominal site near-infrared spectroscopy with gastric tonometry in infants following surgery for congenital heart disease”, Pediatr Crit Care Med9, 62 (2008). doi: http://dx.doi.org/10.1097/01.PCC.0000298640.47574.DA
73.
Gillam-KrakauerM.CochranC.M.SlaughterJ.C.PolavarapuS.McElroyS.J.Hernanz-SchulmanM. and EngelhardtB., “Correlation of abdominal rSO2 with superior mesenteric artery velocities in preterm infants”, J Perinatol33, 609 (2013). doi: http://dx.doi.org/10.1038/jp.2013.3
74.
ZabanehR.N.ClearyJ.P. and LieberC.A., “Mesentric oxygen saturations in premature twins with and without necrotizing enterocolitis”, Pediatr Crit Care Med12, e404 (2011). doi: http://dx.doi.org/10.1097/PCC.0b013e3181fe4278
75.
KissackC.M.GarrR.WardleS.P. and WeindlingA.M., “Cerebral fractional oxygen extraction is inversely correlated with oxygen delivery in the sick, newborn, preterm infant”, J Cereb Blood Flow Metab25, 545 (2005). doi: http://dx.doi.org/9600046
76.
BozzettiV.PaterliniG.MeroniV.DeLorenzoP.GazzoloD.Van BelF.VisserG.H.ValsecchiM. and TagliabueP.E., “Evaluation of splanchnic oximetry, Doppler flow velocimetry in the superior mesenteric artery and feeding tolerance in very low birth weight IUGR and Non-IUGR infants receiving bolus versus continuous enteral nutrition”, BMC Pediatr12, 106 (2012). doi: http://dx.doi.org/1471-2431-12-106
77.
WongF.Y.LeungT.S.AustinT.WilkinsonM.MeekJ.H.WyattJ.S. and WalkerA.M., “Impaired autoregulation in preterm infants identified by using spatially resolved spectroscopy”, Pediatrics121, e604 (2008). doi: http://dx.doi.org/peds.2007-1487
78.
BaileyS.M.Hendricks-MunozK.D. and MallyP., “Splanchnic–cerebral oxygenation ratio (SCOR) values in healthy term infants as measured by near-infrared spectroscopy (NIRS)”, Pediatr Surg Int29, 591 (2013). doi: http://dx.doi.org/10.1007/s00383-013-3285-9
79.
GriffinM.P.O'SheaT.M.BissonetteE.A.HarrellF.E.Jr.LakeD.E. and MoormanJ.R., “Abnormal heart rate characteristics preceding neonatal sepsis and sepsis-like illness”, Pediatr Res53, 920 (2003). doi: http://dx.doi.org/10.1203/01.PDR.0000064904.05313.D2
80.
StoneM.L.TatumP.M.WeitkampJ.H.MukherjeeA.B.AttridgeJ.McGahrenE.D.RodgersB.M.LakeD.E.MoormanJ.R. and FairchildK.D., “Abnormal heart rate characteristics before clinical diagnosis of necrotizing enterocolitis”, J Perinatol33, 847 (2013). doi: http://dx.doi.org/10.1038/jp.2013.63
81.
SullivanB.A.GriceS.M.LakeD.E.MoormanJ.R. and FairchildK.D., “Infection and other clinical correlates of abnormal heart rate characteristics in preterm infants”, J Pediatr164, 775 (2014). doi: http://dx.doi.org/10.1016/j.jpeds.2013.11.038
82.
NaranjoC.A.BustoU.SellersE.M.SandorP.RuizI.RobertsE.A.JanecekE.DomecqC. and GreenblattD.J., “A method for estimating the probability of adverse drug reactions”, Clin Pharmacol Ther30, 239 (1981).
RuizT.L.TrzaskiJ.M.SinkD.W. and HagadornJ.I., “Transcribed oxygen saturation vs oximeter recordings in very low birth weight infants”, J Perinatol34, 130 (2014). doi: http://dx.doi.org/10.1038/jp.2013.157
85.
CambonieG., “NIRS and Doppler to predict NEC in risk neonates (NEONIRS),”vol. 2014. ClinicalTrials.gov (2013).
86.
BasergaM., “Splanchnic Tissue Oxygenation During Enteral Feedings in Anemic Premature Infants at Risk for Necrotizing Enterocolitis,”vol. 2014. ClinicalTrials.gov, (2014).
