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Transfusion associated NEC

Nhan Hyung, Insiyah Campwala, Danilo S Boskovic, Laurel Slater, Yayesh Asmerom, Megan S Holden, Danilyn M Angeles, Gerald Gollin
OBJECTIVE: To determine the incidence of intestinal mucosal injury before and after transfusions in premature infants. STUDY DESIGN: Urine was collected throughout the hospital stay of 62 premature infants and specimens obtained within 24h before and after transfusion were assayed for intestinal fatty acid binding protein (iFABP). A urinary iFABP:creatinine ratio (iFABPu:Cru) of 2.0pg/nmol was considered elevated. RESULT: Forty-nine infants were transfused...
November 6, 2016: Journal of Pediatric Surgery
Susanne Hay, John A F Zupancic, Dustin D Flannery, Haresh Kirpalani, Dmitry Dukhovny
Numerous observational studies appear to demonstrate an association between packed red blood cell (pRBC) transfusions and necrotizing enterocolitis (NEC). However, the limited numbers of randomized controlled trials (RCTs) do not support a causal relationship between pRBC transfusion and NEC. We sought to determine the quality of the evidence behind transfusion-associated necrotizing enterocolitis (TANEC), and to formulate a GRADE-based recommendation regarding transfusion practices to reduce the risk of TANEC...
November 17, 2016: Seminars in Perinatology
Qi Lu, Shupeng Cheng, Min Zhou, Jialin Yu
BACKGROUND: Necrotizing enterocolitis (NEC) in neonates is devastating, and risk-factor identification is crucial. This study aimed to evaluate risk factors for NEC in different gestational age (GA) groups. METHODS: Risk factors associated with NEC were investigated using a retrospective case-control design. Patients with Bell's Stage NEC≥II were divided into three groups based on GA: I, <34 weeks; II, ≥34 weeks but <37 weeks; III, ≥37 weeks. Each case was paired with two GA- and weight-matched controls...
June 22, 2016: Pediatrics and Neonatology
Stefano Ghirardello, Elisa Dusi, Ivan Cortinovis, Stefania Villa, Monica Fumagalli, Massimo Agosti, Silvano Milani, Fabio Mosca
Background The aim of this study was to evaluate the association between red blood cell (RBC) transfusions on the risk of death, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. Study Design and Methods This is an observational study. Data were entered prospectively into the study database at the time of the first transfusion. Clinical characteristics, adverse events, and outcomes of the patients transfused in the first 28 days of life were compared with the population of VLBW infants not transfused during the same period...
January 2017: American Journal of Perinatology
Megan Doty, Christine Wade, Julie Farr, Vanessa Celleri Gomezcoello, Gregory Martin, Tala Nasr
Objective The aim of this study was to determine whether very low-birth-weight (VLBW) infants who had feedings withheld during all blood transfusions had a lower incidence of necrotizing enterocolitis (NEC) compared with infants who were fed during transfusions. Study Design A retrospective chart review over a 3-year period in a level-3 neonatal intensive care unit was conducted. A total of 108 inborn VLBW infants (weight range: 500-1,500 g) who had received a transfusion before 36 weeks were reviewed. Diagnosis of NEC (≥ Bell stage II), demographics, feeds, transfusions, outcomes, and variables associated with NEC were collected...
July 2016: American Journal of Perinatology
Arash J Sayari, Jun Tashiro, Juan E Sola, Eduardo A Perez
PURPOSE: We sought to investigate the association between blood transfusions (BT), rates of necrotizing enterocolitis requiring surgical intervention (SNEC), and survival. METHODS: Blood transfusions in premature infants were identified in the Kids' Inpatient Database (2003-2009). Propensity score-matched analysis compared SNEC outcomes in BT vs. non-BT groups. Multivariate analyses were performed to determine independent predictors of outcome. RESULTS: Overall, 663740 cases were identified and 4...
June 2016: Journal of Pediatric Surgery
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
Dongli Song, Priya Jegatheesan, Glenn DeSandre, Balaji Govindaswami
BACKGROUND: Delayed cord clamping (DCC, ≥30 s) increases blood volume in newborns and is associated with fewer blood transfusions and short-term neonatal complications. The optimal timing of cord clamping for very preterm infants should maximize placental transfusion without interfering with stabilization and resuscitation. AIM: We compared the effect of different durations of DCC, 30-45 s vs. 60-75 s, on delivery room (DR) and neonatal outcomes in preterm infants <32 weeks gestational age (GA)...
2015: PloS One
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
T T B Ho, M W Groer, A A Luciano, A Schwartz, M Ji, B S Miladinovic, A Maheshwari, T L Ashmeade
OBJECTIVE: We hypothesized that red blood cell (RBC) transfusions influence intestinal inflammation in very low birth weight (VLBW) infants. We also suspected that hematocrit (Hct) at transfusions and RBC storage time correlate with intestinal inflammation. STUDY DESIGN: VLBW infants, without major congenital defects, intestinal perforation or necrotizing enterocolitis, were enrolled prospectively. Fecal calprotectin (FC) levels were measured from stool samples collected before and after RBC transfusions...
October 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
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
Beena G Sood, Anupama Rambhatla, Ronald Thomas, Xinguang Chen
BACKGROUND AND OBJECTIVES: Many observational studies reporting a temporal association between red cell transfusions (RBCTs) and necrotizing enterocolitis (NEC) in preterm infants fail to take into account RBCTs in infants without NEC. The objective of this study was to investigate the association between RBCTs and NEC in an analytical retrospective cohort study with minimization of selection and measurement bias and controlling for clinical covariates. METHODS: Inborn preterm infants [23-32 weeks gestational age (GA)] without major congenital anomalies were eligible...
March 2016: Journal of Maternal-fetal & Neonatal Medicine
Dan Dang, Chuan Zhang, Shan Shi, Xin Mu, Xiaoming Lv, Hui Wu
AIM: To assess effects of umbilical cord milking (UCM) on early blood pressure stabilization, hemoglobin (Hb), as well as incidence of transfusion and complications in preterm infants. METHODS: This meta-analysis was conducted by searching the Pubmed, EMBASE and Cochrane Library (until July 2014) databases. Any clinical trials, including randomized control trials, comparing UCM to immediate cord clamping (ICC) were analyzed. RESULTS: Six studies were included in this meta-analysis...
June 2015: Journal of Obstetrics and Gynaecology Research
Huiqing Sun, Yan Zhou, Hong Xiong, Wengqing Kang, Bangli Xu, Dapeng Liu, Xiaoli Zhang, Huixia Li, Chongchen Zhou, Yinghui Zhang, Mingjin Zhou, Qingping Meng
OBJECTIVE: To evaluate the prognosis of very preterm infants with severe respiratory distress syndrome (RDS) receiving mechanical ventilation. METHODS: A total of 288 preterm infants mechanically ventilated for severe RDS and completed follow-up till 18 months of corrected age comprised these study subjects. The associations of prenatal and postnatal factors, mode and duration of conventional mechanical ventilation (CMV), medication and treatment, and complications with cerebral palsy or mental developmental index (MDI) < 70 at 18 months of age were analyzed...
April 2015: Lung
K AlFaleh, A Al-Jebreen, A Baqays, A Al-Hallali, K Bedaiwi, N Al-Balahi, A AlGhamdi, T AlKharfi, A Alzahem
OBJECTIVE: To investigate the association of PRBC transfusion and the development of NEC in VLBW preterm infants at a tertiary care neonatal unit. METHODS: A retrospective case-control study was performed. All VLBW infants (gestational age ≤32 week and birth weight <1500 g) born between 1999 and 2013 were included. Cases and controls were divided into four groups: (1) Infants who received PRBC transfusion and developed NEC within 48 hours of transfusion; (2) Infants who received PRBC transfusion and did not develop NEC; (3) Infant who developed NEC and did not receive PRBC transfusion; and (4) Infants who neither developed NEC nor received PRBC transfusion...
January 1, 2014: Journal of Neonatal-perinatal Medicine
Antonio Del Vecchio
Thrombocytopenia is a very frequent problem among sick neonates, affecting up to 35% of all infants admitted to the neonatal intensive care unit (NICU), and serves as an important indicator of multiple clinical conditions. The cause of the thrombocytopenia is unclear in up to 60% of affected neonates. A clinical classification of thrombocytopenia is based on the time of presentation, early (≤72 hours of life) vs. late (>72 hours of life). Early thrombocytopenia is commonly associated with feto-maternal conditions, is most commonly caused by disorders associated with placental insufficiency, and is generally mild to moderate and resolves spontaneously within 7-10 days without any intervention...
September 2014: Early Human Development
Nilay Hakan, Aysegul Zenciroglu, Mustafa Aydin, Nurullah Okumus, Arzu Dursun, Dilek Dilli
OBJECTIVE: The aim of present study was to evaluate the indications and the complications associated with neonatal exchange transfusion (ET) performed for hyperbilirubinemia. METHODS: This study included overall 306 neonates who underwent ET between 2005 and 2012. The demographic characteristics of patients, causes of jaundice and adverse events occurred during or within 1 week after ET were recorded from their medical files. Those newborns that underwent ET were classified as either "otherwise healthy" or "sick" group...
September 2015: Journal of Maternal-fetal & Neonatal Medicine
R Sharma, D F Kraemer, R M Torrazza, V Mai, J Neu, J J Shuster, M L Hudak
OBJECTIVE: Recent reports have posited a temporal association between blood transfusion with packed red blood cells (BT) and necrotizing enterocolitis (NEC). We evaluated the relationship between BT and NEC among infants at three hospitals who were consented at birth into a prospective observational study of NEC. STUDY DESIGN: We used a case-control design to match each case of NEC in our study population of infants born at<33 weeks postmenstrual age (PMA) to one control infant using hospital of birth, PMA, birth weight and date of birth...
November 2014: Journal of Perinatology: Official Journal of the California Perinatal Association
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