Assessment of Cerebral, Renal, and Hepatic Tissue Oxygenation Changes in Neonates Given Fresh Frozen Plasma

Assessment of Cerebral, Renal, and Hepatic Tissue Oxygenation Changes in Neonates Given Fresh Frozen Plasma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Cerebral, Renal, and Hepatic Tissue Oxygenation Changes in Neonates Given Fresh Frozen Plasma Ahmet Burak Tüzüner, Hüseyin Pür, Ahmet Özdemir This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7842977/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 16 You are reading this latest preprint version Abstract Background: This study aimed to evaluate changes in cerebral, hepatic, and renal tissue oxygenation in neonates receiving fresh frozen plasma (FFP) via near-infrared spectroscopy (NIRS) and to assess correlations with vital signs and laboratory parameters. Methods: This single-center prospective observational study was conducted in a neonatal intensive care unit and included neonates who received fresh frozen plasma (FFP) infusion. Cerebral (right and left), hepatic, and renal tissue oxygenation were continuously monitored via a four-channel near-infrared spectroscopy (NIRS) device during FFP infusion and for six hours thereafter. In addition, body weight, birth weight, exposure to prenatal steroids, sex, postnatal age, hemoglobin concentration, blood gas parameters, blood glucose levels, and vital signs were recorded for each patient. Results: Twenty-four infants (gestational age 24–41.2 weeks) were included. No significant changes were observed in cerebral or hepatic tissue oxygenation after FFP infusion. However, renal tissue oxygenation significantly increased at hour 2 compared with that at hour 1 and at hour 6 compared with that at hours 0 and 5. A positive correlation was also found between changes in the left cerebral and hepatic NIRS values over the 6-hour period. Conclusion: While FFP infusion did not significantly alter cerebral or hepatic oxygenation, it was associated with improved renal NIRS values, suggesting a selective positive effect on somatic perfusion. Moreover, the observed correlation between cerebral and hepatic NIRS changes indicates that FFP may exert parallel effects across cerebral and somatic regions. Fresh frozen plasma NIRS neonatal intensive care cerebral oxygenation renal oxygenation tissue perfusion Introduction Fresh frozen plasma (FFP) is a component prepared from either whole blood or apheresis plasma; it is frozen at an appropriate temperature for a duration that preserves the functionality of labile coagulation factors and is used for transfusion or fractionation purposes [ 1 ]. It contains numerous procoagulant and inhibitor components of the coagulation cascade, acute phase proteins, immunoglobulins, and albumin [ 2 ]. Currently, FFP is frequently administered to neonates for various indications, including the correction of coagulopathy-related bleeding, the management of disseminated intravascular coagulation (DIC), the prevention of intracranial hemorrhage (ICH), the treatment of critically ill and unstable infants (such as supportive therapy for sepsis or volume expansion), and the correction of prolonged coagulation parameters without active bleeding [3.12,13,14]. Near-infrared spectroscopy (NIRS) is a "noninvasive" method used for assessing tissue oxygenation. Originally employed to evaluate cerebral oxygenation, this technology has evolved to be used across various age groups and for numerous purposes over time. Changes in regional tissue oxygenation detected by NIRS reflect the balance between oxygen consumption and oxygen delivery at multiple organ levels [ 4 , 10 , 11 ]. Today, NIRS devices are routinely used in neonatal and pediatric intensive care units as well as during congenital heart surgeries at many advanced centers [ 15 , 16 ]. A review of the literature indicates that numerous studies have examined the effects of RBC transfusions and volume expanders on tissue oxygenation via NIRS. However, data regarding the impact of FFP transfusion on tissue oxygenation remain limited. In this study, we planned to compare cerebral, hepatic, and renal oxygenation values both within and between these organs over a 6-hour recording period in patients receiving FFP. We aimed to illustrate the changes in ratios and differences between these regions with FFP administration and evaluate their impact on patients’ vital signs (heart rate, respiratory rate, blood pressur and temperature). Materials and methods This study was designed as an observational prospective study and was conducted on patients admitted to the intensive care unit at Erciyes University Fevzi Mercan Children's Health and Diseases Hospital, Kayseri, Türkiye. Patients were included between April 2019 and November 2019. Following approval from the institutional ethics committee and the acquisition of informed consent from the parents, neonates born between 25 and 42 weeks of gestation who received FFP for various indications were enrolled in the study. Patients with cyanotic congenital heart disease or major congenital and chromosomal anomalies were excluded. For each patient, the following variables were recorded: body weight, birth weight, exposure to prenatal steroids, sex, postnatal age, hemoglobin concentration, blood gas parameters, and blood glucose levels. The indications for FFP infusion were active bleeding, prolonged PT and PTT, and hemodynamic instability. In all patients, the NIRS device INVOS 5100 C Cerebral/Somatic Oximeter (Medtronic), which is routinely used in our unit, was employed during fluid loading. A four-channel NIRS probe (right cerebral, left cerebral, liver, and left kidney) was attached to the patients 10–60 minutes before transfusion, and recordings were made for 6 hours. Data obtained from the NIRS device were transferred to Excel, where averages of the data were calculated for the 5 minutes before the start of FFP transfusion. During follow-up, averages of the data from the first 5 minutes of each hour were calculated on the basis of the start time of the infusion. All the statistical analyses were performed via IBM SPSS for Windows Version 22.0. Numerical variables are summarized as the mean ± standard deviation and median (minimum–maximum) values. Categorical variables are presented as and percentages. The Mann‒Whitney U test was used to investigate differences between two groups for numerical variables, whereas the Friedman test was used for comparisons involving more than two groups. Differences between two groups with paired variables were examined via the Wilcoxon test. Spearman and Pearson correlation coefficients were used to assess correlations between different variables. The correlation coefficients (r) from the Pearson and Spearman analyses were classified as follows: 0–0.25 (weak), 0.26–0.50 (moderate), 0.51–0.75 (strong), and 0.76–1 (very strong). The significance level was set at p < 0.05. Odds ratios (ORs) and confidence intervals (CIs) were calculated to assess risk factors. Results Twenty-four infants were included in this study. Among the patients, 7 (29.1%) were female, and 17 (70.8%) were male. The mean gestational age of the patients was 31.4 ± 5.3 weeks (range: 24–41.2 weeks), and 19 (79.2%) were preterm. The mean weight of the patients was 1714 ± 995 grams (range: 570–3950 grams). All patients were delivered via C-section. The mean hemoglobin level of the patients was 13.2 ± 2.8 mg/dl (range: 8.8–20.0), the mean PT value was 18.3 ± 9.5 (range: 10.5–53.0), and the mean PTT value was 39.8 ± 11.7 (range: 18–65.7) (Table 1 ). Table 1 Demographics of the study group Min–Max Median Mean ± SD. % Gestational age 24.0 - 41.2 31.0 31.4 ± 5.3 Weight (gram) 570 - 3950 1490 1714 ± 995 Term 5 20.8% Preterm 19 79.20% Gender Female 7 29.1% Male 17 70.8% Maternal Steroid Application (-) 9 37.50% (+) 15 62.5% Mode of Delivery C-Section 24 100% Vaginal Delivery 0 0.0% Hb 8.8 - 20.0 12.4 13.2 ± 2.8 PT 10.5 - 53.0 15.2 18.3 ± 9.5 aPTT 18.0 - 65.7 36.7 39.8 ± 11.7 aPTT: Activated partial thromboplastin time, PT: Prothrombin time, Hb: Hemoglobin When the liver NIRS parameters of the patients following FFP administration were examined, the mean value measured at each hour did not significantly differ from the initial mean value or the mean value from the previous hour (Table 2 ). In contrast, when the renal NIRS parameters were evaluated, a statistically significant increase was observed in the mean measured at the 6th hour compared with the 5th hour and the initial mean NIRS value. Additionally, the mean NIRS value measured at the 2nd hour was significantly greater than the mean value measured at the 1st hour. However, no significant differences were found in the mean values measured at each hour compared with the initial value and the mean value from the previous hour (Table 2 ). Table 2 Comparison of Liver and Renal NIRS Values with FFP Min–Max Median Mean ± SD p* pǂ Liver NIRS 0.Hour 16–93 61.5 56.7 ± 20.9 1.Hour 16–94 63 57.8 ± 21 0.883 E 2.Hour 16–95 65.5 60.2 ± 22 0.166 E 0.175 E 3.Hour 16–96 62 55.5 ± 22.4 0.629 E 0.079 E 4.Hour 16–97 60 56.4 ± 24.1 0.719 E 0.933 E 5.Hour 16–98 57 54.4 ± 25 0.132 E 0.25 E 6.Hour 16–99 59 58.3 ± 23.5 0.807 E 0.544 E Kidney NIRS 0.Hour 15–94 60 53 ± 23.7 1.Hour 15–95 56.5 51.8 ± 23.7 0,392 E 2.Hour 15–94 59 55 ± 22.3 0,121 E 0,032 E 3.Hour 15–95 61 53.4 ± 22.8 0,564 E 0,569 E 4.Hour 15–95 54 54 ± 21.1 0,443 E 0,796 E 5.Hour 15–95 54 53.1 ± 22.4 0,708 E 0,693 E 6.Hour 15–95 63 56.9 ± 23.8 0,041 E 0,032 E p * Change compared to hour 0/p ǂ Change compared to the previous measurement Statistically significant values are indicated in bold. At baseline, a statistically significant (p < 0.05) positive correlation was observed between the right cerebral NIRS value and the renal NIRS, liver NIRS, and hemoglobin (Hgb) levels (Table 3 ). At hour 0, a statistically significant (p < 0.05) positive correlation was found between the liver NIRS value and the renal NIRS, Hgb, and blood glucose levels. Additionally, a statistically significant (p < 0.05) negative correlation was observed between the liver NIRS value and the HCO3 and base excess (BE) values at hour 0 (Table 3 ). Table 3 Comparison of Hour 0 NIRS Values with Blood Gas Parameters, Respiratory Rate, Saturation, Heart Rate, Hemoglobin (Hgb), PT, PTT, and Blood Glucose Levels 0 Hour Left Cerebral NIRS Right cerebral NIRS Liver NIRS Kidney NIRS r P r p r p r p Right Cerebral NIRS 0.696 0 Liver NIRS 0.711 0 0.576 0 Kidney NIRS 0.297 0.056 0.328 0.034 0.179 0.256 pH -0.116 0.501 -0.275 0.105 -0.168 0.328 -0.019 0.913 CO2 -0.131 0.446 0.085 0.622 -0.12 0.488 0.013 0.941 HCO3 -0.376 0.024 -0.281 0.097 -0.358 0.032 -0.009 0.957 BE -0.335 0.046 -0.29 0.087 -0.356 0.033 -0.005 0.975 Lactat -0.087 0.613 -0.188 0.271 -0.321 0.056 -0.178 0.299 Respiratory Rate -0.066 0.684 0.054 0.742 0.013 0.937 0.189 0.243 SaO2 0.093 0.559 0.195 0.215 -0.535 0.535 0.047 0.77 Hearth Rate 0.172 0.277 0.085 0.594 0.008 0.962 0.09 0.571 Hb 0.573 0 0.49 0.001 0.612 0 -0.036 0.824 PT 0.165 0.451 0.203 0.352 -0.161 0.464 0.047 0.83 PTT 0.131 0.551 -0.135 0.538 0.005 0.983 -0.006 0,977 Blood Glucose 0.243 0.142 0.216 0.192 0.412 0.01 -0.038 0,821 aPTT: Activated partial thromboplastin time, PT: Prothrombin time, Hb: Hemoglobin, BE: Base excess, SaO2: Oxygen saturation Spearman correlations. r: two-variable ratio. p < 0.05 was considered statistically significant, and significant values are shown in bold. A statistically significant (p < 0.05) positive correlation was observed between the change in left cerebral NIRS and the change in liver NIRS from baseline to hour 6 (Table 4 ). Table 4 Comparison of Hour-6 NIRS values with blood gas parameters, respiratory rate, saturation, heart rate, hemoglobin (Hgb), PT, PTT, and blood glucose levels Left Cerebral NIRS Right Cerebral NIRS Liver NIRS Renal NIRS r p r p r p r p Right Cerebral NIRS 0.261 0.109 Liver NIRS 0.348 0.032 0.114 0.497 Renal NIRS 0.155 0.353 0.138 0.409 0.062 0.714 pH -0.078 0.682 0.074 0.696 -0.208 0.278 0.291 0.125 CO2 -0.246 0.19 0.038 0.843 -0.045 0.817 -0.359 0.056 HCO3 0.135 0.475 -0.011 0.954 -0.015 0.937 -0.021 0.915 BE 0.086 0.65 -0.154 0.417 0.247 0.197 0.106 0.583 Lactate -0.349 0.064 -0.185 0.338 -0.163 0.408 -0.019 0.924 Respiratory Rate 0.065 0.705 0.306 0.07 0.107 0.54 0.179 0.303 SaO2 0.248 0.128 0.054 0.745 0.366 0.024 0.168 0.313 Hearth Rate 0.179 0.276 -0.054 0.743 -0.089 0.594 0.013 0.94 Blood Glucose -0.247 0.153 -0.122 0.486 -0.07 0.695 0.264 0.132 Hb: hemoglobin, BE: base excess, SaO2: oxygen saturation Spearman correlations. r: two-variable ratio. p < 0.05 was considered statistically significant, and significant values are shown in bold. Discussion To our knowledge, this is the first study that assessed cerebral, renal, and hepatic tissue oxygenation changes in neonates given fresh frozen plasma. When we examine studies on erythrocyte transfusion, Aktaş et al. reported increased abdominal and renal perfusion, along with higher abdominal/cerebral and renal/cerebral ratios, in preterm infants with Hgb < 8 mg/dl after erythrocyte transfusion, accompanied by reductions in heart and respiratory rates [ 6 ]. Similarly, Sandal et al. reported that erythrocyte transfusion increased somatic NIRS values, the somatic/cerebral ratio, and pulse oximetry saturation while reducing lactate levels and heart rate [ 9 ]. In our study, however, analysis of somatic (renal and hepatic) and cerebral (right and left) NIRS values before and after FFP infusion revealed no statistically significant changes at 1 or 6 hours. A review of the literature on volume expanders, revealed that, during hypovolemia, sympathetic activation redistributes blood flow to preserve cerebral autoregulation, thereby maintaining cerebral perfusion at the expense of peripheral tissues. This redistribution results in reduced NIRS values in somatic regions. Hanson et al. reported that fluid resuscitation improved renal but not cerebral oxygenation in younger children, with no significant changes in adolescents, likely reflecting age-related physiological differences [ 7 ]. In our study, FFP infusion did not significantly affect cerebral or hepatic oxygenation, but renal NIRS values increased at several time points. This finding is consistent with Hanson et al. and suggests that the kidney may be a more sensitive marker of somatic perfusion than the liver is, where technical limitations, such as portal flow and dual circulation, may complicate monitoring. Abdominal NIRS monitoring can also be influenced by intestinal peristalsis, further limiting reliability. For these reasons, the renal region, with its more homogeneous tissue, appears to provide more consistent results. Using four probes, we monitored the right and left cerebral, hepatic, and renal regions simultaneously for six hours, allowing comparative evaluation of different tissues. While no significant changes were observed in hepatic NIRS, renal NIRS values increased significantly at hour 6 compared with those at baseline and hour 5, or at hour 2 compared with those at hour 1. These results support the reliability of renal monitoring for assessing somatic perfusion. When cerebral and somatic tissues were analyzed separately, no significant pre-or postinfusion changes were detected. However, a significant positive correlation was found between changes in left cerebral and hepatic NIRS from hour 0 to hour 6, suggesting that FFP may exert similar effects on both cerebral and somatic regions. Kooi et al. reported that rehydration therapy improved blood pressure in neonates with impaired perfusion, yet no significant changes in cerebral NIRS parameters were observed. They attributed this to sufficient baseline cerebral blood flow despite low mean arterial pressure or to the limited effects of volume expanders on cerebral circulation [ 8 ]. Similarly, in our study, cerebral NIRS values did not significantly change following FFP infusion. Overall, these findings indicate that FFP exerts a selective positive effect on renal oxygenation, whereas cerebral and hepatic oxygenation remain stable. This highlights the potential value of renal NIRS monitoring in critically ill neonates as a reliable indicator of somatic perfusion. In conclusion, while FFP infusion did not significantly alter cerebral or hepatic oxygenation, it was associated with improved renal NIRS values, suggesting a selective positive effect on somatic perfusion. Moreover, the observed correlation between cerebral and hepatic NIRS changes indicates that FFP may exert parallel effects across cerebral and somatic regions. Declarations Author contributions Ahmet Burak Tüzüner(Corresponding Author) and Hüseyin Pür revised manuscript, Ahmet Özdemir performed the quality assessment Data availability Data from this study can be found in the included references. Funding The authors received no specific funding for this work. Consent for publication Not applicable. Publication was approved by our local institutional review board: Erciyes University Ethics Committee, Erciyes School of Medicine and Health. Informed consent to participate was obtained from the parents or legal guardians of all minors included in this study. Competing interests The authors declare that they have no competing interests. Clinical trial registration Not applicable Ethical approval Publication was approved by our local institutional review board: Erciyes University Ethics Committee, Erciyes School of Medicine and Health. Informed consent to participate was obtained from the parents or legal guardians of all minors included in this study. Acknowledgements The authors would like to thank Dr. Salih Demirhan and Dr. Abdullah Tozluyurt for their valuable advice and support throughout this study. References Turkish Ministry of Health National Blood and Blood Products Guide: Turkish Blood Centers and Transfusion Association; 2011. Venkatesh V, Khan R, Curley A, New H, Stanworth S. How we decide when a neonate needs a transfusion. British journal of hematology. 2013;160(4):421-33. Perk Y AB, Çetinkaya M. Turkish Neonatology Society Blood Products Transfusion Guide. Turkish Neonatology Society; 2016. p. 35-37. Chakravarti S, Srivastava S, Mittnacht AJ. Near infrared spectroscopy (NIRS) in children. Semin Cardiothorac Vasc Anesth. Mar 2008;12(1):70-79. Sean M. Bailey , Karen D. Hendricks-Muñoz , John T. Wells , Pradeep Mally. Packed Red Blood Cell Transfusion Increases Regional Cerebral and Splanchnic Tissue Oxygen Saturation in Anemic Symptomatic Preterm Infants Am J Perinatol 2010; 27(6): 445-453 DOI: 10.1055/s-0030-1247598 Aktas S, Ergenekon E, Ozcan E, et al. Effects of blood transfusion on regional tissue oxygenation in preterm newborns are dependent on the degree of anemia. J Paediatr Child Health. 2019:1-5. doi:10.1111/jpc.14378 Hanson, S.J., et al., Effect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy. Pediatr Emerg Care, 2009. 25(3): p. 150-3. Kooi EM, van der Laan ME, Verhagen EA, Van Braeckel KN, Bos AF. Volume expansion does not alter cerebral tissue oxygen extraction in preterm infants with clinical signs of poor perfusion. Neonatology. 2013;103(4):308‐314. doi:10.1159/000346383. Gonca Sandal, Serife S. Oguz, Omer Erdeve, Melek Akar, Nurdan Uras, Ugur Dilmen. Assessment of red blood cell transfusion and transfusion duration on cerebral and mesenteric oxygenation using near-infrared spectroscopy in preterm infants with symptomatic anemia, 2013. doi.org/10.1111/trf.12359 Grizelj R, Ryll MJ, Bojanić K, Ćaleta T, Dessardo NS, Vukšić I, et al. Regional cerebral oxygen saturation references in extremely and very preterm neonates using neonatal sensors: a prospective observational cohort study. BMJ Open. 2025;9:e003239. Seager E, Longley C, Aladangady N, Banerjee J. Measurement of gut oxygenation in the neonatal population using near-infrared spectroscopy: a clinical tool? Arch Dis Child Fetal Neonatal Ed. 2020 Jan;105(1):76-86. doi: 10.1136/archdischild-2018-316750. Epub 2019 Jun 1. Motta M, Del Vecchio A, Perrone B, et al. Fresh frozen plasma use in the NICU: a prospective, observational, multi study. Arch Dis Child Fetal Neonatal Ed. 2014;99:F303–8. doi: 10.1136/archdischild-2013-304747. Stanworth SJ, Grant-Casey J, Lowe D, et al. The use of fresh-frozen plasma in England: high levels of inappropriate use in adults and children. Transfusion. 2011;51:62–70. doi: 10.1111/j.1537-2995.2010.02798.x. Sokou R, Parastatidou S, Konstantinidi A, et al. Fresh frozen plasma transfusion in the neonatal population: A systematic review. Blood Rev. 2022;55:100951. doi: 10.1016/j.blre.2022.100951. Nhu N Tran, Michelle Tran, Jeraldine Lopez, Maxine Ogbaa, Jodie K Votava-Smith, Ken M Brady Near-Infrared Spectroscopy: Clinical Use in High-Risk Neonates Neonatal Netw. 2021 Mar 1;40(2):73-79. doi: 10.1891/0730-0832/11-T-678. Terri Marin , Understanding Near-Infrared Spectroscopy: An Update Crit Care Nurs Clin North Am. 2024 Mar;36(1):41-50. doi: 10.1016/j.cnc.2023.08.001. Epub 2023 Sep 9. Additional Declarations No competing interests reported. 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It contains numerous procoagulant and inhibitor components of the coagulation cascade, acute phase proteins, immunoglobulins, and albumin [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Currently, FFP is frequently administered to neonates for various indications, including the correction of coagulopathy-related bleeding, the management of disseminated intravascular coagulation (DIC), the prevention of intracranial hemorrhage (ICH), the treatment of critically ill and unstable infants (such as supportive therapy for sepsis or volume expansion), and the correction of prolonged coagulation parameters without active bleeding [3.12,13,14].\u003c/p\u003e\u003cp\u003eNear-infrared spectroscopy (NIRS) is a \"noninvasive\" method used for assessing tissue oxygenation. Originally employed to evaluate cerebral oxygenation, this technology has evolved to be used across various age groups and for numerous purposes over time. Changes in regional tissue oxygenation detected by NIRS reflect the balance between oxygen consumption and oxygen delivery at multiple organ levels [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eToday, NIRS devices are routinely used in neonatal and pediatric intensive care units as well as during congenital heart surgeries at many advanced centers [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A review of the literature indicates that numerous studies have examined the effects of RBC transfusions and volume expanders on tissue oxygenation via NIRS. However, data regarding the impact of FFP transfusion on tissue oxygenation remain limited. In this study, we planned to compare cerebral, hepatic, and renal oxygenation values both within and between these organs over a 6-hour recording period in patients receiving FFP. We aimed to illustrate the changes in ratios and differences between these regions with FFP administration and evaluate their impact on patients\u0026rsquo; vital signs (heart rate, respiratory rate, blood pressur and temperature).\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003e This study was designed as an observational prospective study and was conducted on patients admitted to the intensive care unit at Erciyes University Fevzi Mercan Children's Health and Diseases Hospital, Kayseri, T\u0026uuml;rkiye. Patients were included between April 2019 and November 2019.\u003c/p\u003e\u003cp\u003eFollowing approval from the institutional ethics committee and the acquisition of informed consent from the parents, neonates born between 25 and 42 weeks of gestation who received FFP for various indications were enrolled in the study. Patients with cyanotic congenital heart disease or major congenital and chromosomal anomalies were excluded.\u003c/p\u003e\u003cp\u003eFor each patient, the following variables were recorded: body weight, birth weight, exposure to prenatal steroids, sex, postnatal age, hemoglobin concentration, blood gas parameters, and blood glucose levels. The indications for FFP infusion were active bleeding, prolonged PT and PTT, and hemodynamic instability.\u003c/p\u003e\u003cp\u003eIn all patients, the NIRS device INVOS 5100 C Cerebral/Somatic Oximeter (Medtronic), which is routinely used in our unit, was employed during fluid loading. A four-channel NIRS probe (right cerebral, left cerebral, liver, and left kidney) was attached to the patients 10\u0026ndash;60 minutes before transfusion, and recordings were made for 6 hours. Data obtained from the NIRS device were transferred to Excel, where averages of the data were calculated for the 5 minutes before the start of FFP transfusion. During follow-up, averages of the data from the first 5 minutes of each hour were calculated on the basis of the start time of the infusion.\u003c/p\u003e\u003cp\u003eAll the statistical analyses were performed via IBM SPSS for Windows Version 22.0. Numerical variables are summarized as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation and median (minimum\u0026ndash;maximum) values. Categorical variables are presented as and percentages. The Mann‒Whitney U test was used to investigate differences between two groups for numerical variables, whereas the Friedman test was used for comparisons involving more than two groups. Differences between two groups with paired variables were examined via the Wilcoxon test. Spearman and Pearson correlation coefficients were used to assess correlations between different variables. The correlation coefficients (r) from the Pearson and Spearman analyses were classified as follows: 0\u0026ndash;0.25 (weak), 0.26\u0026ndash;0.50 (moderate), 0.51\u0026ndash;0.75 (strong), and 0.76\u0026ndash;1 (very strong). The significance level was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Odds ratios (ORs) and confidence intervals (CIs) were calculated to assess risk factors.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTwenty-four infants were included in this study. Among the patients, 7 (29.1%) were female, and 17 (70.8%) were male. The mean gestational age of the patients was 31.4\u0026thinsp;\u0026plusmn;\u0026thinsp;5.3 weeks (range: 24\u0026ndash;41.2 weeks), and 19 (79.2%) were preterm. The mean weight of the patients was 1714\u0026thinsp;\u0026plusmn;\u0026thinsp;995 grams (range: 570\u0026ndash;3950 grams). All patients were delivered via C-section. The mean hemoglobin level of the patients was 13.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8 mg/dl (range: 8.8\u0026ndash;20.0), the mean PT value was 18.3\u0026thinsp;\u0026plusmn;\u0026thinsp;9.5 (range: 10.5\u0026ndash;53.0), and the mean PTT value was 39.8\u0026thinsp;\u0026plusmn;\u0026thinsp;11.7 (range: 18\u0026ndash;65.7) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographics of the study group\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u003cp\u003eMin\u0026ndash;Max\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMedian\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c9\" namest=\"c7\"\u003e\u003cp\u003eMean \u0026plusmn; SD. %\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eGestational age\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e41.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e31.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e31.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026plusmn;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e5.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eWeight (gram)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e570\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3950\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1490\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1714\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026plusmn;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e995\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTerm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e20.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePreterm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e79.20%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e29.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e70.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMaternal Steroid Application\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(-)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e37.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(+)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e62.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMode of Delivery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eC-Section\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" 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colname=\"c6\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026plusmn;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e2.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e53.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e18.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026plusmn;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e9.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eaPTT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e65.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e39.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026plusmn;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e11.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eaPTT: Activated partial thromboplastin time, PT: Prothrombin time, Hb: Hemoglobin\u003c/p\u003e\u003cp\u003eWhen the liver NIRS parameters of the patients following FFP administration were examined, the mean value measured at each hour did not significantly differ from the initial mean value or the mean value from the previous hour (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn contrast, when the renal NIRS parameters were evaluated, a statistically significant increase was observed in the mean measured at the 6th hour compared with the 5th hour and the initial mean NIRS value. Additionally, the mean NIRS value measured at the 2nd hour was significantly greater than the mean value measured at the 1st hour. However, no significant differences were found in the mean values measured at each hour compared with the initial value and the mean value from the previous hour (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Liver and Renal NIRS Values with FFP\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMin\u0026ndash;Max\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMedian\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep*\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003epǂ\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eLiver NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e0.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u0026ndash;93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e56.7\u0026thinsp;\u0026plusmn;\u0026thinsp;20.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e1.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u0026ndash;94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e57.8\u0026thinsp;\u0026plusmn;\u0026thinsp;21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.883 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e2.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u0026ndash;95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e60.2\u0026thinsp;\u0026plusmn;\u0026thinsp;22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.166 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.175 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e3.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u0026ndash;96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e55.5\u0026thinsp;\u0026plusmn;\u0026thinsp;22.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.629 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.079 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e4.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u0026ndash;97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e56.4\u0026thinsp;\u0026plusmn;\u0026thinsp;24.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.719 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.933 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e5.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u0026ndash;98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e54.4\u0026thinsp;\u0026plusmn;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.132 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.25 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e6.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u0026ndash;99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e58.3\u0026thinsp;\u0026plusmn;\u0026thinsp;23.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.807 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.544 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eKidney NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e0.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u0026ndash;94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e53\u0026thinsp;\u0026plusmn;\u0026thinsp;23.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e1.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u0026ndash;95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e51.8\u0026thinsp;\u0026plusmn;\u0026thinsp;23.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0,392 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e2.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u0026ndash;94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e55\u0026thinsp;\u0026plusmn;\u0026thinsp;22.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0,121 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0,032 E\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e3.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u0026ndash;95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e53.4\u0026thinsp;\u0026plusmn;\u0026thinsp;22.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0,564 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0,569 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e4.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u0026ndash;95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e54\u0026thinsp;\u0026plusmn;\u0026thinsp;21.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0,443 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0,796 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e5.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u0026ndash;95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e53.1\u0026thinsp;\u0026plusmn;\u0026thinsp;22.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0,708 E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0,693 E\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e6.Hour\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u0026ndash;95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e56.9\u0026thinsp;\u0026plusmn;\u0026thinsp;23.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0,041 E\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0,032 E\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003ep * Change compared to hour 0/p ǂ Change compared to the previous measurement\u003c/p\u003e\u003cp\u003eStatistically significant values are indicated in bold.\u003c/p\u003e\u003cp\u003eAt baseline, a statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) positive correlation was observed between the right cerebral NIRS value and the renal NIRS, liver NIRS, and hemoglobin (Hgb) levels (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAt hour 0, a statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) positive correlation was found between the liver NIRS value and the renal NIRS, Hgb, and blood glucose levels. Additionally, a statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) negative correlation was observed between the liver NIRS value and the HCO3 and base excess (BE) values at hour 0 (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Hour 0 NIRS Values with Blood Gas Parameters, Respiratory Rate, Saturation, Heart Rate, Hemoglobin (Hgb), PT, PTT, and Blood Glucose Levels\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e\u003cp\u003e0 Hour\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eLeft Cerebral NIRS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eRight cerebral NIRS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eLiver NIRS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003eKidney NIRS\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRight Cerebral NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.696\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiver NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.711\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.576\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKidney NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.297\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.056\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.328\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.034\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.179\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.256\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003epH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.501\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.275\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.168\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.328\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.913\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCO2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.131\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.446\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.085\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.622\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.488\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.941\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCO3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.376\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0.024\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.281\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.097\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.358\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.032\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.009\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.957\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBE\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.335\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0.046\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.356\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.033\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.975\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLactat\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.613\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.188\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.271\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.321\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.056\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.178\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRespiratory Rate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.684\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.054\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.742\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.937\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.189\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.243\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaO2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.093\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.559\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.195\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.215\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.535\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.535\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.047\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHearth Rate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.172\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.277\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.085\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.594\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.962\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.571\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHb\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.573\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.612\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.036\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.824\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.451\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.203\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.352\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.161\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.464\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.047\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePTT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.131\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.551\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.538\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.983\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0,977\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlood Glucose\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.243\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.142\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.216\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.412\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.01\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0,821\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eaPTT: Activated partial thromboplastin time, PT: Prothrombin time, Hb: Hemoglobin, BE: Base excess, SaO2: Oxygen saturation\u003c/p\u003e\u003cp\u003eSpearman correlations.\u003c/p\u003e\u003cp\u003er: two-variable ratio.\u003c/p\u003e\u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant, and significant values are shown in bold.\u003c/p\u003e\u003cp\u003eA statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) positive correlation was observed between the change in left cerebral NIRS and the change in liver NIRS from baseline to hour 6 (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Hour-6 NIRS values with blood gas parameters, respiratory rate, saturation, heart rate, hemoglobin (Hgb), PT, PTT, and blood glucose levels\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLeft Cerebral NIRS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eRight Cerebral NIRS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eLiver NIRS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eRenal NIRS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003er\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRight Cerebral NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.261\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiver NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.348\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e0.032\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.497\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRenal NIRS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.155\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.353\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.138\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.409\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.062\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.714\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003epH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.078\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.682\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.074\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.696\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.208\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.278\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.291\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.125\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCO2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.246\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.843\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.045\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.817\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.359\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.056\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCO3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.475\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.954\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.937\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.021\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.915\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBE\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.086\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.154\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.417\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.247\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.583\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLactate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.349\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.064\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.185\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.338\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.163\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.408\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.924\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRespiratory Rate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.705\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.306\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.179\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.303\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaO2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.248\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.054\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.745\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.366\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.024\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.168\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.313\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHearth Rate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.179\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.276\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.054\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.743\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.089\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.594\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.94\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlood Glucose\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.247\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.122\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.486\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.695\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.264\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.132\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eHb: hemoglobin, BE: base excess, SaO2: oxygen saturation\u003c/p\u003e\u003cp\u003eSpearman correlations.\u003c/p\u003e\u003cp\u003er: two-variable ratio.\u003c/p\u003e\u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant, and significant values are shown in bold.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo our knowledge, this is the first study that assessed cerebral, renal, and hepatic tissue oxygenation changes in neonates given fresh frozen plasma.\u003c/p\u003e\u003cp\u003eWhen we examine studies on erythrocyte transfusion, Aktaş et al. reported increased abdominal and renal perfusion, along with higher abdominal/cerebral and renal/cerebral ratios, in preterm infants with Hgb\u0026thinsp;\u0026lt;\u0026thinsp;8 mg/dl after erythrocyte transfusion, accompanied by reductions in heart and respiratory rates [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Similarly, Sandal et al. reported that erythrocyte transfusion increased somatic NIRS values, the somatic/cerebral ratio, and pulse oximetry saturation while reducing lactate levels and heart rate [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In our study, however, analysis of somatic (renal and hepatic) and cerebral (right and left) NIRS values before and after FFP infusion revealed no statistically significant changes at 1 or 6 hours.\u003c/p\u003e\u003cp\u003eA review of the literature on volume expanders, revealed that, during hypovolemia, sympathetic activation redistributes blood flow to preserve cerebral autoregulation, thereby maintaining cerebral perfusion at the expense of peripheral tissues. This redistribution results in reduced NIRS values in somatic regions. Hanson et al. reported that fluid resuscitation improved renal but not cerebral oxygenation in younger children, with no significant changes in adolescents, likely reflecting age-related physiological differences [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn our study, FFP infusion did not significantly affect cerebral or hepatic oxygenation, but renal NIRS values increased at several time points. This finding is consistent with Hanson et al. and suggests that the kidney may be a more sensitive marker of somatic perfusion than the liver is, where technical limitations, such as portal flow and dual circulation, may complicate monitoring. Abdominal NIRS monitoring can also be influenced by intestinal peristalsis, further limiting reliability. For these reasons, the renal region, with its more homogeneous tissue, appears to provide more consistent results.\u003c/p\u003e\u003cp\u003eUsing four probes, we monitored the right and left cerebral, hepatic, and renal regions simultaneously for six hours, allowing comparative evaluation of different tissues. While no significant changes were observed in hepatic NIRS, renal NIRS values increased significantly at hour 6 compared with those at baseline and hour 5, or at hour 2 compared with those at hour 1. These results support the reliability of renal monitoring for assessing somatic perfusion.\u003c/p\u003e\u003cp\u003eWhen cerebral and somatic tissues were analyzed separately, no significant pre-or postinfusion changes were detected. However, a significant positive correlation was found between changes in left cerebral and hepatic NIRS from hour 0 to hour 6, suggesting that FFP may exert similar effects on both cerebral and somatic regions.\u003c/p\u003e\u003cp\u003eKooi et al. reported that rehydration therapy improved blood pressure in neonates with impaired perfusion, yet no significant changes in cerebral NIRS parameters were observed. They attributed this to sufficient baseline cerebral blood flow despite low mean arterial pressure or to the limited effects of volume expanders on cerebral circulation [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Similarly, in our study, cerebral NIRS values did not significantly change following FFP infusion.\u003c/p\u003e\u003cp\u003eOverall, these findings indicate that FFP exerts a selective positive effect on renal oxygenation, whereas cerebral and hepatic oxygenation remain stable. This highlights the potential value of renal NIRS monitoring in critically ill neonates as a reliable indicator of somatic perfusion.\u003c/p\u003e\u003cp\u003eIn conclusion, while FFP infusion did not significantly alter cerebral or hepatic oxygenation, it was associated with improved renal NIRS values, suggesting a selective positive effect on somatic perfusion. Moreover, the observed correlation between cerebral and hepatic NIRS changes indicates that FFP may exert parallel effects across cerebral and somatic regions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAhmet Burak T\u0026uuml;z\u0026uuml;ner(Corresponding Author) and H\u0026uuml;seyin P\u0026uuml;r revised manuscript, Ahmet \u0026Ouml;zdemir performed the quality assessment\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData from this study can be found in the included references.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no specific funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003ePublication was approved by our local institutional review board: Erciyes University Ethics Committee, Erciyes School of Medicine and Health. Informed consent to participate was obtained from the parents or legal guardians of all minors included in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePublication was approved by our local institutional review board: Erciyes University Ethics Committee, Erciyes School of Medicine and Health. Informed consent to participate was obtained from the parents or legal guardians of all minors included in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank \u003cstrong\u003eDr. Salih Demirhan\u003c/strong\u003e and \u003cstrong\u003eDr. Abdullah Tozluyurt\u003c/strong\u003e for their valuable advice and support throughout this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eTurkish Ministry of Health National Blood and Blood Products Guide: Turkish Blood Centers and Transfusion Association; 2011.\u003c/li\u003e\n \u003cli\u003eVenkatesh V, Khan R, Curley A, New H, Stanworth S. How we decide when a neonate needs a transfusion. British journal of hematology. 2013;160(4):421-33.\u003c/li\u003e\n \u003cli\u003ePerk Y AB, \u0026Ccedil;etinkaya M. Turkish Neonatology Society Blood Products Transfusion Guide. Turkish Neonatology Society; 2016. p. 35-37.\u003c/li\u003e\n \u003cli\u003eChakravarti S, Srivastava S, Mittnacht AJ. Near infrared spectroscopy (NIRS) in children. Semin Cardiothorac Vasc Anesth. Mar 2008;12(1):70-79.\u003c/li\u003e\n \u003cli\u003eSean M. Bailey , Karen D. Hendricks-Mu\u0026ntilde;oz , John T. Wells , Pradeep Mally. Packed Red Blood Cell Transfusion Increases Regional Cerebral and Splanchnic Tissue Oxygen Saturation in Anemic Symptomatic Preterm Infants Am J Perinatol 2010; 27(6): 445-453\u003cbr\u003eDOI: 10.1055/s-0030-1247598\u003c/li\u003e\n \u003cli\u003eAktas S, Ergenekon E, Ozcan E, et al. Effects of blood transfusion on regional tissue oxygenation in preterm newborns are dependent on the degree of anemia. J Paediatr Child Health. 2019:1-5. doi:10.1111/jpc.14378\u003c/li\u003e\n \u003cli\u003eHanson, S.J., et al., Effect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy. Pediatr Emerg Care, 2009. 25(3): p. 150-3.\u003c/li\u003e\n \u003cli\u003eKooi EM, van der Laan ME, Verhagen EA, Van Braeckel KN, Bos AF. Volume expansion does not alter cerebral tissue oxygen extraction in preterm infants with clinical signs of poor perfusion. Neonatology. 2013;103(4):308‐314. doi:10.1159/000346383.\u003c/li\u003e\n \u003cli\u003eGonca Sandal, Serife S. Oguz, Omer Erdeve, Melek Akar, Nurdan Uras, Ugur Dilmen. Assessment of red blood cell transfusion and transfusion duration on cerebral and mesenteric oxygenation using near-infrared spectroscopy in preterm infants with symptomatic anemia, 2013. doi.org/10.1111/trf.12359\u003c/li\u003e\n \u003cli\u003eGrizelj R, Ryll MJ, Bojanić K, Ćaleta T, Dessardo NS, Vuk\u0026scaron;ić I, et al. Regional cerebral oxygen saturation references in extremely and very preterm neonates using neonatal sensors: a prospective observational cohort study. BMJ Open. 2025;9:e003239.\u003c/li\u003e\n \u003cli\u003eSeager E, Longley C, Aladangady N, Banerjee J. Measurement of gut oxygenation in the neonatal population using near-infrared spectroscopy: a clinical tool? Arch Dis Child Fetal Neonatal Ed. 2020 Jan;105(1):76-86. doi: 10.1136/archdischild-2018-316750. Epub 2019 Jun 1.\u003c/li\u003e\n \u003cli\u003eMotta M, Del Vecchio A, Perrone B, et al. Fresh frozen plasma use in the NICU: a prospective, observational, multi study. Arch Dis Child Fetal Neonatal Ed. 2014;99:F303\u0026ndash;8. doi: 10.1136/archdischild-2013-304747.\u003c/li\u003e\n \u003cli\u003eStanworth SJ, Grant-Casey J, Lowe D, et al. The use of fresh-frozen plasma in England: high levels of inappropriate use in adults and children. Transfusion. 2011;51:62\u0026ndash;70. doi: 10.1111/j.1537-2995.2010.02798.x.\u003c/li\u003e\n \u003cli\u003eSokou R, Parastatidou S, Konstantinidi A, et al. Fresh frozen plasma transfusion in the neonatal population: A systematic review. Blood Rev. 2022;55:100951. doi: 10.1016/j.blre.2022.100951.\u003c/li\u003e\n \u003cli\u003eNhu N Tran, Michelle Tran, Jeraldine Lopez, Maxine Ogbaa, Jodie K Votava-Smith, Ken M Brady Near-Infrared Spectroscopy: Clinical Use in High-Risk Neonates Neonatal Netw. 2021 Mar 1;40(2):73-79. doi: 10.1891/0730-0832/11-T-678.\u003c/li\u003e\n \u003cli\u003eTerri Marin , Understanding Near-Infrared Spectroscopy: An Update Crit Care Nurs Clin North Am. 2024 Mar;36(1):41-50. doi: 10.1016/j.cnc.2023.08.001. Epub 2023 Sep 9.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Fresh frozen plasma, NIRS, neonatal intensive care, cerebral oxygenation, renal oxygenation, tissue perfusion","lastPublishedDoi":"10.21203/rs.3.rs-7842977/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7842977/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e This study aimed to evaluate changes in cerebral, hepatic, and renal tissue oxygenation in neonates receiving fresh frozen plasma (FFP) via near-infrared spectroscopy (NIRS) and to assess correlations with vital signs and laboratory parameters.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis single-center prospective observational study was conducted in a neonatal intensive care unit and included neonates who received fresh frozen plasma (FFP) infusion. Cerebral (right and left), hepatic, and renal tissue oxygenation were continuously monitored via a four-channel near-infrared spectroscopy (NIRS) device during FFP infusion and for six hours thereafter. In addition, body weight, birth weight, exposure to prenatal steroids, sex, postnatal age, hemoglobin concentration, blood gas parameters, blood glucose levels, and vital signs were recorded for each patient.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Twenty-four infants (gestational age 24–41.2 weeks) were included. No significant changes were observed in cerebral or hepatic tissue oxygenation after FFP infusion. However, renal tissue oxygenation significantly increased at hour 2 compared with that at hour 1 and at hour 6 compared with that at hours 0 and 5. A positive correlation was also found between changes in the left cerebral and hepatic NIRS values over the 6-hour period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eWhile FFP infusion did not significantly alter cerebral or hepatic oxygenation, it was associated with improved renal NIRS values, suggesting a selective positive effect on somatic perfusion. Moreover, the observed correlation between cerebral and hepatic NIRS changes indicates that FFP may exert parallel effects across cerebral and somatic regions.\u003c/p\u003e","manuscriptTitle":"Assessment of Cerebral, Renal, and Hepatic Tissue Oxygenation Changes in Neonates Given Fresh Frozen Plasma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-21 06:59:22","doi":"10.21203/rs.3.rs-7842977/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-18T23:35:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-18T18:14:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-18T09:01:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"87277426210580866339396511590393019545","date":"2026-02-18T08:41:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"178837902952517733756429264511152740013","date":"2026-02-17T20:51:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"225891548702531167943619487565611239616","date":"2026-02-17T20:16:23+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-17T18:06:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"139304202293475860636437584496967120349","date":"2026-02-17T17:40:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"45181871394050925872284273269731143336","date":"2026-02-17T17:39:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"338353575756709677236594233750922893803","date":"2025-12-04T09:13:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"51770885373643004876195700144988295428","date":"2025-10-29T11:59:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-29T11:38:19+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-21T10:28:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-18T10:37:53+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-18T10:36:41+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2025-10-12T21:11:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"254e360b-57e1-4cc8-8729-b4f3d3b0e284","owner":[],"postedDate":"October 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-03T14:38:28+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-21 06:59:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7842977","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7842977","identity":"rs-7842977","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}