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Transfusion related NEC

Arne Ohlsson, Sanjay M Aher
BACKGROUND: Preterm infants have low plasma levels of erythropoietin (EPO), providing a rationale for the use of erythropoiesis-stimulating agents (ESAs) to prevent or treat anaemia and to provide neuro protection and protection against necrotising enterocolitis (NEC). Darbepoetin (Darbe) and EPO are currently available ESAs. OBJECTIVES: To assess the effectiveness and safety of ESAs (erythropoietin (EPO) and/or Darbe) initiated early (before eight days after birth) compared with placebo or no intervention in reducing red blood cell (RBC) transfusions, adverse neurological outcomes, and feeding intolerance including necrotising enterocolitis (NEC) in preterm and/or low birth weight infants...
November 16, 2017: Cochrane Database of Systematic Reviews
Canfeng Yu, Huifan Li, Qiannan Zhang, Huayun He, Xinhong Chen, Ziyu Hua
OBJECTIVES: This study was intended to explore the etiology and risk factors of severe neonatal hyperbilirubinemia and to analyze the adverse events associated with ECT (Exchange Transfusion), as well as to identify the factors related to the poor prognosis. METHODS: All of the full-term neonates who had undergone ECT for hyperbilirubinemia at Children's Hospital of Chongqing Medical University from January 2001 to December 2011 were enrolled in this study. General demographic characteristics, comorbidities, pre- and post-exchange TSB(Total Serum Bilirubin) levels, duration and frequency of ECT, and clinical outcomes were recorded and analyzed anonymously...
2017: PloS One
Maria M Talavera, Gary Bixler, Corin Cozzi, James Dail, Randy R Miller, Richard McClead, Kristina Reber
OBJECTIVE: To reduce the incidence of necrotizing enterocolitis (NEC) among very low birth weight (VLBW) infants admitted to 8 intensive care nurseries from a 2010 baseline of 8.0% to <4.0% by 2012 and sustain for 6 months using quality improvement (QI) methodology. METHODS: A multidisciplinary NEC QI team used the Vermont Oxford Network definition of NEC and the Institute for Healthcare Improvement model. The specific aims were evidenced based and included (1) standardized early human milk feedings, (2) conservative feeding guidelines during blood transfusions and indomethacin treatment, and (3) restriction of ranitidine use in VLBW infants...
May 2016: Pediatrics
Zlatan Zvizdic, Suada Heljic, Nusret Popovic, Jasmina Alajbegovic-Halimic, Emir Milisic, Asmir Jonuzi
BACKGROUND: necrotizing enterocolitis is a serious condition that affects mostly preterm infants, with high mortality rate. AIM: to estimate the influence of potentially contributing factors of this multifactorial disease. METHODS: the study group included 51 necrotizing enterocolitis infants who were less than 37 week gestation who were hospitalized in NICU during a five year period. The control group consisted of 71 patients with approximately the same gestational age and birth weight...
February 2016: Materia Socio-medica
Ravi M Patel, Andrea Knezevic, Neeta Shenvi, Michael Hinkes, Sarah Keene, John D Roback, Kirk A Easley, Cassandra D Josephson
IMPORTANCE: Data regarding the contribution of red blood cell (RBC) transfusion and anemia to necrotizing enterocolitis (NEC) are conflicting. These associations have not been prospectively evaluated, accounting for repeated, time-varying exposures. OBJECTIVE: To determine the relationship between RBC transfusion, severe anemia, and NEC. DESIGN, SETTING, AND PARTICIPANTS: In a secondary, prospective, multicenter observational cohort study from January 2010 to February 2014, very low-birth-weight (VLBW, ≤1500 g) infants, within 5 days of birth, were enrolled at 3 level III neonatal intensive care units in Atlanta, Georgia...
March 1, 2016: JAMA: the Journal of the American Medical Association
Kypros H Nicolaides, Argyro Syngelaki, Liona C Poon, Catalina de Paco Matallana, Walter Plasencia, Francisca S Molina, Gemma Picciarelli, Natasa Tul, Ebru Celik, Tze Kin Lau, Roberto Conturso
BACKGROUND: Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth...
January 2016: American Journal of Obstetrics and Gynecology
E Weiner, N Fainstein, L Schreiber, R Sagiv, J Bar, M Kovo
OBJECTIVE: To study the contribution of umbilical cord (UC) abnormalities in emergent cesarean deliveries (ECDs) for non-reassuring fetal heart rate (NRFHR) and to explore their association with placental histopathology and neonatal outcome. STUDY DESIGN: Data from 530 ECDs for NRFHR were reviewed for the occurrence of UC abnormalities. Those included the presence of UC entanglements, the number and location of loops, true knots and short cord (<50 cm). Multiple UC entanglements were defined as ⩾ 2 UC loops...
November 2015: Journal of Perinatology: Official Journal of the California Perinatal Association
Miguel Couselo, Rosa Fonseca, Lucía Mangas, Juan José Vila
Introduction The extent of intestinal damage in transfusion-associated necrotizing enterocolitis (TNEC) has been scarcely studied. The aim of this investigation was to study surgical findings in TNEC and determine their severity considering the extent of the disease and risk of bowel perforation. Materials and Methods Neonates who required surgical treatment for necrotizing enterocolitis (NEC) were studied retrospectively. Patients who developed NEC within 48 hours after a red blood cell transfusion (RBCT) formed group TR48 and patients who did not receive a RBCT 48 hours before the diagnosis of NEC became group CN (conventional NEC)...
June 2016: European Journal of Pediatric Surgery
B Say, F N Sari, S S Oguz, H Degirmencioglu, S Arayici, G Kadioglu Simsek, E G Ibrisim, U Dilmen
OBJECTIVE: Leukocyte contamination during blood transfusion can cause many adverse effects. Filtration can be performed either at bedside during the transfusion or as pre-storage filtration. Pre-storage filtration is superior to bedside filtration because leukocytes are removed prior to storage, thus preventing further adverse effects associated with the storage of these cells. METHODS AND MATERIALS: One hundred and six infants were randomised into two groups: pre-storage filtration (group 1, n = 53) and bedside filtration (group 2, n = 53)...
June 2015: Transfusion Medicine
Kenneth E Remy, Charles Natanson, Harvey G Klein
PURPOSE OF REVIEW: This article will analyze and evaluate the current evidence regarding the use of older, longer-stored red blood cells (RBCs) for transfusion in pediatric patients and will examine some of the postulated mechanisms of injury related to prolonged refrigerated storage of RBCs and studies reporting clinical outcomes. RECENT FINDINGS: Three randomized controlled trials and seven observational studies have been conducted entirely in pediatric patients...
June 2015: Current Opinion in Pediatrics
Sean M Bailey, Karen D Hendricks-Muñoz, Pradeep V Mally
BACKGROUND: There is increasing evidence indicating an association between red blood cell (RBC) transfusions and necrotising enterocolitis (NEC) in preterm infants, especially late-onset NEC. This phenomenon is referred to as transfusion-related acute gut injury (TRAGI). One theory as to a pathophysiological mechanism is that transfusion may result in an ischemia-reperfusion injury to intestinal tissue. We tested the hypothesis that there is significantly greater variability during transfusion in splanchnic tissue oxygen saturation (SrSO2) than in cerebral tissue oxygen saturation (CrSO2)...
July 2015: Blood Transfusion, Trasfusione del Sangue
Eran Weiner, Jacob Bar, Nataly Fainstein, Letizia Schreiber, Avi Ben-Haroush, Michal Kovo
OBJECTIVE: To correlate between intraoperative findings, placental histopathology and neonatal outcome in emergent cesarean deliveries (ECD) for non-reassuring fetal heart rate (NRFHR). STUDY DESIGN: Data on ECD for NRFHR were reviewed for labor, documented intraoperative findings, neonatal outcome parameters and placental histopathology reports. Results were compared between those with and without intraoperative findings. Placental lesions were classified to those related to maternal underperfusion or fetal thrombo-occlusive disease, and those related to maternal (MIR) and fetal (FIR) inflammatory responses...
February 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Stijn Bekkers, Arjan G J Bot, Dennis Makarawung, Valentin Neuhaus, David Ring
BACKGROUND: The National Hospital Discharge Survey (NHDS) and the Nationwide Inpatient Sample (NIS) collect sample data and publish annual estimates of inpatient care in the United States, and both are commonly used in orthopaedic research. However, there are important differences between the databases, and because of these differences, asking these two databases the same question may result in different answers. The degree to which this is true for arthroplasty-related research has, to our knowledge, not been characterized...
November 2014: Clinical Orthopaedics and related Research
Michal Kovo, Letizia Schreiber, Osnat Elyashiv, Avi Ben-Haroush, Golan Abraham, Jacob Bar
OBJECTIVE: To compare pregnancy outcome and placental pathology in pregnancies complicated by fetal growth restriction (FGR) with and without preeclampsia. METHODS: Labor, fetal/neonatal outcome, and placental pathology parameters from neonates with a birth weight below the 10 th percentile (FGR), born between 24 and 42 weeks of gestation, were reviewed. Results were compared between pregnancies complicated with preeclampsia (hypertensive FGR [H-FGR]) to those without preeclampsia (normotensive FGR [N-FGR])...
March 2015: Reproductive Sciences
Terri Marin, Cassandra D Josephson, Niki Kosmetatos, Melinda Higgins, James E Moore
OBJECTIVE: To evaluate the mesenteric tissue oxygenation response in preterm infants fed and not fed during red blood cell (RBC) transfusions. STUDY DESIGN: Prospective, observational comparison of mesenteric oxygenation using near-infrared spectroscopy in preterm infants (<33 weeks' at birth) who were fed or not fed during RBC transfusion. Tissue oxygenation means were examined up to 48 hours after each transfusion event. RESULTS: Mean mesenteric regional oxygen saturation (rSO2) slopes during RBC transfusion of fed (n = 9) vs not fed (n = 8) infants ranged from -0...
September 2014: Journal of Pediatrics
Chris Derienzo, P Brian Smith, David Tanaka, Nicholas Bandarenko, Mary Lee Campbell, Annadele Herman, Ronald N Goldberg, C Michael Cotten
AIMS: The objective of this study is to determine the incidence of and risk factors for necrotizing enterocolitis (NEC) and transfusion-associated NEC (TANEC) in very-low-birth-weight (VLBW) infants pre/post implementation of a peri-transfusion feeding protocol. STUDY DESIGN: A retrospective cohort study was conducted including all inborn VLBW infants admitted to the Duke intensive care nursery from 2002 to 2010. We defined NEC using Bell's modified criteria IIA and higher and TANEC as NEC occurring within 48h of a packed red blood cell (pRBC) transfusion...
May 2014: Early Human Development
Mohamad Tammam Elabiad, Mimily Harsono, Ajay J Talati, Ramasubbareddy Dhanireddy
CONTEXT: Reports evaluating a possible association between necrotising enterocolitis (NEC) and blood transfusion have been predominantly case-control studies. As the possible associations of disease with any variable on which cases and controls have been matched cannot be explored, a cohort study would offer a solution to this problem. OBJECTIVE: Our objective was to evaluate the association between exposure to a packed red blood cell (PRBC) transfusion and development of NEC in a cohort where biases of matching are omitted...
2013: BMJ Open
Terri Marin, Ora L Strickland
Necrotizing enterocolitis (NEC) is a disease primarily of prematurity characterized by partial or entire gut necrosis and is associated with significant mortality and morbidity. Recent studies report that approximately 25% to 35% of very low-birth-weight infants less than 1500 g receiving packed red blood cell transfusions develop temporally associated NEC, known as transfusion-related NEC (TR-NEC). Although there are many known risk factors for NEC, this article focuses on 3 contributing factors: packed red blood cell transfusions, enteral feedings, and gastrointestinal immaturity...
June 2013: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
P Wan-Huen, D Bateman, D M Shapiro, E Parravicini
OBJECTIVE: To determine whether a temporal association exists between antecedent packed red blood cell (PRBC) transfusions and necrotizing enterocolitis (NEC) in premature infants. STUDY DESIGN: This case-control study included inborn infants from a single center who developed NEC during a 2-year period. For every NEC infant, two matched controls from the same period were chosen based on gestational age and birth weight. Transfusion-related NEC was defined as antecedent PRBC transfusion within 48 h prior to the onset of any symptoms attributable to NEC...
October 2013: Journal of Perinatology: Official Journal of the California Perinatal Association
Terri Marin, James Moore, Niki Kosmetatos, John D Roback, Paul Weiss, Melinda Higgins, Linda McCauley, Ora L Strickland, Cassandra D Josephson
BACKGROUND: Recent evidence suggests that antecedent red blood cell (RBC) transfusions increase the risk for necrotizing enterocolitis (NEC), the most common gastrointestinal emergency encountered by very-low-birthweight (VLBW) infants. The underlying mechanism for this association is unknown. Altered oxygenation of the mesenteric vasculature during RBC transfusion has been hypothesized to contribute to NEC development and was investigated in this study. STUDY DESIGN AND METHODS: Oxygenation patterns among four VLBW infants who developed transfusion-related NEC (TR-NEC) were compared to four VLBW infants with similar gestational age who were transfused but did not develop NEC (non-NEC)...
November 2013: Transfusion
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