Relationship between packed red blood cell transfusion and severe form of necrotizing enterocolitis: A case control study

BACKGROUND:Lack of recent studies focusing on indications, pattern, and benefits of transfusions in low birth weight (B.Wt) and low gestational age (GA) preterm neonates prompted us to undertake this study.AIM:To estimate the transfusion requirements and outcomes in preterm neonates <1500 g and/or <32 weeks.SETTINGS AND DESIGN:This is a cross-sectional study conducted over a period of 2 years in a tertiary care center.MATERIALS AND METHODS:This study was conducted with 101 preterm neonates <1500 g and/or <32 weeks who received blood transfusions in the Neonatal Intensive Care Unit. Restrictive pattern of transfusion was followed. Demographic details and antenatal, neonatal, laboratory, and transfusion parameters were collected.STATISTICAL ANALYSIS USED:Statistical analyses were performed using SPSS 16.RESULTS:The study participants received 311 transfusions. Transfusion requirements decreased with increasing GA and B.Wt. Majority of blood transfusions occurred during the first 2 weeks of life. Packed red blood cells (PRBCs) were the most frequent blood components transfused. Ninety-six percent of the study population had an uneventful transfusion. Mean hemoglobin improvement after PRBC transfusions was 2.3 ± 2.1 g/dl. Improvement in apnea occurred in 76% PRBC transfusions. Infants with sepsis, patent ductus arteriosus, bronchopulmonary dysplasia, disseminated intravascular coagulation, and dyselectrolytemia received more number of transfusions.CONCLUSION:This study would serve as an audit for neonatal blood transfusion therapy. Close adherence to neonatal transfusion policy and restrictive transfusion guidelines helps reduce inappropriate use of blood products and adverse transfusion reactions.

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“…[ 50 ] However, other studies have found an association between number of transfusions and incidence of ROP, BPD, and NEC. [ 48 51 52 ]…”

Section: Discussionmentioning

confidence: 99%

Transfusion support in preterm neonates <1500 g and/or <32 weeks in a tertiary care center: A descriptive study

Priya

Krishnamoorthy

Panicker

et al. 2018

Asian J Transfus Sci

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“…So far, the etiology of NEC is still multifactorial (7,8). In pathological morphology, decreased perfusion and ischemia of the intestinal wall may cause disruption of the intestinal barrier, which enables bacterial infection and inflammation (9)(10)(11)(12)(13)(14)(15). It is crucial for suspected neonates to receive diagnostics and appropriate treatment as early as possible.…”

Section: ' Introductionmentioning

confidence: 99%

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Gao

Mao

et al. 2021

Clinics

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OBJECTIVE: This study aimed to identify the most useful ultrasound (US) features associated with definite neonatal necrotizing enterocolitis (NEC) and their prognostic values, particularly the calculated markers combined with important features. METHODS: A total of 213 suspected NEC cases were collected from the neonatal department of our hospital from January 2015 to August 2017. Each infant received both X-ray and US examinations. RESULTS: No differences were found in sex composition and delivery modes between groups. NEC-positive neonates had poorer prognosis compared to negative ones. The NEC group showed a higher frequency of abnormal signals. US showed higher NEC-related frequencies in different parameters. A variable (named predictor in US [PUS]) with five features was constructed. For NEC diagnosis, this variable provided a much higher area under the curve Q2 (AUC) (0.965) than other parameters. In this model, PUS had a cutoff value of 0.376 with a 0.900 sensitivity and 0.922 specificity. In prognosis, the closest factors were selected to draw a receiver operating characteristic curve, as well as a novel calculated variable US prognostic (USPro) marker. USPro had a much higher AUC (0.86) than other single features and showed a cutoff value of 0.18145, with 0.75 sensitivity and 0.84 specificity. This variable had a weaker power in prognosis when compared with PUS in diagnosis. CONCLUSIONS: The application of abdominal color Doppler US can provide high accuracy and sensitivity in NEC diagnosis and also contribute to its prognosis, without induction of radiation. Suspected neonates should be examined using this technique as early as possible.

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“…The number of infants enrolled in the study was 444. The overall median (IQR) gestational age and birth weight values of the enrolled infants were 29 (27,31) wk and 1112.5 (860-1315) g, respectively. Most of the infants were born in the hospital (401/444, 90%).…”

Section: Resultsmentioning

confidence: 99%

Risk of Necrotizing Enterocolitis Following Packed Red Blood Cell Transfusion in Very Low Birth Weight Infants

et al. 2019

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Objective To evaluate the association between red blood cell (RBC) transfusion leading to necrotizing enterocolitis (NEC) within 48 h, known as transfusion-associated necrotizing enterocolitis (TANEC). Methods A nested case-control study using historical data was conducted in the neonatal intensive care unit of Songklanagarind Hospital, Thailand. All very low birth weight (VLBW) infants delivered between November 2009 and July 2016 were enrolled. The infants were identified as RBC transfusion received and NEC developed. Logistic regression was used to evaluate risk factors for transfusion and the association between RBC transfusion and NEC. Results Four hundred and forty-four VLBW infants were enrolled in the study. The median (interquartile range) gestational age was 29 (27, 31) wk. The overall incidence of NEC was 13%. Three (5.2%) of the NEC infants had TANEC. The infants who received RBC transfusion had a lower gestational age [odds ratio, OR 0.64; 95% confidence interval (95%CI) 0.57, 0.73, p < 0.001] and were more likely to have pneumonia (OR 9.86; 95%CI 5.02, 19.35, p < 0.001) or to have received H 2 blocker (OR 2.92; 95%CI 1.73, 4.93, p < 0.001). The ORs (95% CI) after adjusting for confounders, the association between RBC transfusion and NEC for transfusions ≤2 d, >2 to 4 d, and > 4 to 6 d prior to NEC were 1.83 (0.41, 8.16; p = 0.43), 1.7 (0.26, 11.16; p = 0.58) and 1.19 (0.31, 4.62; p = 0.80) respectively. Conclusions After controlling of confounders, no evidence of association was found between RBC transfusion and TANEC.

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Relationship between packed red blood cell transfusion and severe form of necrotizing enterocolitis: A case control study

Abstract: Blood Transfusion associated necrotizing enterocolitis is a severe, mainly surgical form of disease.

Cited by 20 publications

References 20 publications

Transfusion support in preterm neonates <1500 g and/or <32 weeks in a tertiary care center: A descriptive study

Transfusion support in preterm neonates <1500 g and/or <32 weeks in a tertiary care center: A descriptive study

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Risk of Necrotizing Enterocolitis Following Packed Red Blood Cell Transfusion in Very Low Birth Weight Infants

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