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PRBC transfusion and preterm

L White, M Said, K Rais-Bahrami
OBJECTIVE: To monitor altered mesenteric tissue oxygen saturation (StO2) before and after blood transfusion. METHODS: We placed a 4-wavelength NIRS sensor (FORE-SIGHT, CASMED, Branford, CT USA) on the right lower abdominal quadrant prior to transfusion and measured StO2 for up to 48 hours post transfusion. Pulse oximetry (SpO2) data was collected simultaneously, with fractional tissue oxygen extraction (FTOE) and the [SpO2-StO2] difference calculated to normalize for hypoxic episodes...
2015: Journal of Neonatal-perinatal Medicine
Angie C Jelin, Marya G Zlatnik, Miriam Kuppermann, Steven E Gregorich, Sanae Nakagawa, Ronald Clyman
OBJECTIVE: Randomized controlled trials have demonstrated that delayed umbilical cord clamping (DCC) in preterm infants results in improved neonatal outcomes, including increased hematocrit, and decreased rates of intraventricular hemorrhage (IVH) and packed red blood cell transfusions. We hypothesized that implementation of a DCC policy in preterm infants would result in similarly improved outcomes, despite initial clinician resistance. STUDY DESIGN: A DCC policy (30-60 s) for singleton infants <35 weeks gestation was implemented in September 2011...
2016: Journal of Maternal-fetal & Neonatal Medicine
Hijab Zubairi, Paul Visintainer, Jennie Fleming, Matthew Richardson, Rachana Singh
BACKGROUND: Preterm infants may inadvertently be exposed to lead from the packed red blood cell (pRBC) transfusions with almost no or very limited data available. The aim of the study was to quantify this exposure in preterm infants ≤30 wk gestational age (GA). METHODS: Prospective cohort study, infants ≤30 wk GA were eligible, infants < 23 wk GA and known chromosomal diseases were excluded. Blood lead levels (BLLs) were obtained at birth, before and after each transfusion, and at discharge...
June 2015: Pediatric Research
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
Alireza A Shamshirsaz, Karin A Fox, Bahram Salmanian, Concepcion R Diaz-Arrastia, Wesley Lee, B Wycke Baker, Jerasimos Ballas, Qian Chen, Teelkien R Van Veen, Pouya Javadian, Haleh Sangi-Haghpeykar, Nicholas Zacharias, Stephen Welty, Christopher I Cassady, Amirhossein Moaddab, Edwina J Popek, Shiu-ki Rocky Hui, Jun Teruya, Venkata Bandi, Michael Coburn, Thomas Cunningham, Stephanie R Martin, Michael A Belfort
OBJECTIVE: The purpose of this study was to test the hypothesis that a standardized multidisciplinary treatment approach in patients with morbidly adherent placenta, which includes accreta, increta, and percreta, is associated with less maternal morbidity than when such an approach is not used (nonmultidisciplinary approach). STUDY DESIGN: A retrospective cohort study was conducted with patients from 3 tertiary care hospitals from July 2000 to September 2013. Patients with histologically confirmed placenta accreta, increta, and percreta were included in this study...
February 2015: American Journal of Obstetrics and Gynecology
Serdar Alan, Saadet Arsan, Emel Okulu, Ilke M Akin, Atila Kilic, Salih Taskin, Esra Cetinkaya, Omer Erdeve, Begum Atasay
OBJECTIVE: The aim of this study was to evaluate the effects of umbilical cord milking (UCM) on the need for packed red blood cell (PRBC) transfusion and hematologic and hemodynamic parameters in very-low-birth-weight infants. METHODS: The infants were randomized into 2 groups: group 1 (UCM) and group 2 (control). The primary outcome was the number of PRBC transfusions during the first 35 days of life. The secondary outcome measures were the hemodynamic variables during the first 24 hours of life...
November 2014: Journal of Pediatric Hematology/oncology
Zhiqun Zhang, Xianmei Huang, Hui Lu
Anemia and the need for transfusion of packed red blood cells (PRBCs) are common in preterm infants. PRBC transfusion increases the oxygen carrying capacity of hemoglobin and may result in higher rates of organ dysfunction. To determine whether PRBC transfusion in preterm infants is associated with an increased incidence of bronchopulmonary dysplasia (BPD), this retrospective study was performed on neonates with birth weights ≤ 1,500 g or gestational age ≤ 32 weeks admitted from August, 2008 to November, 2013...
2014: Scientific Reports
Autumn S Kiefer, Thomas Fleming, George J Eckert, Brenda B Poindexter, Peter P Nawroth, Mervin C Yoder
BACKGROUND: Preterm infants have a greater risk of necrotizing enterocolitis following transfusion. It is hypothesized that high glucose concentrations in red blood cell (RBC) preservatives lead to increased methylglyoxal (MG) metabolism, causing glycation-driven damage to transfused RBCs. Such changes to the RBCs could promote a proinflammatory state in transfusion recipients. METHODS: Standard and washed RBCs in Adsol-3, two common neonatal preparations, were studied...
March 2014: Pediatric Research
Jayasree Nair, Sylvia F Gugino, Lori C Nielsen, Cheryl Allen, James A Russell, Bobby Mathew, Daniel D Swartz, Satyan Lakshminrusimha
BACKGROUND: Cases of necrotizing enterocolitis occurring within 48 h of packed red blood cell (PRBC) transfusions are increasingly being described in observational studies. Transfusion-associated gut injury is speculated to result from an abnormal mesenteric vascular response to transfusion. However, the mechanism of disruption of the balance between mesenteric vasoconstriction and relaxation following transfusion is not known. METHODS: Preterm lambs (n = 16, 134 d gestation; term: 145-147 d) were delivered and ventilated for 24 h...
December 2013: Pediatric Research
Ahmed Mahmoud Abdel Hadi, Islam Shereen Hamdy
BACKGROUND: This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP) in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012. METHODS: A prospective cohort study was undertaken in infants weighing < 1250 g and maternal postmenstrual age < 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP...
2013: Clinical Ophthalmology
Alexandra Luton
Necrotizing enterocolitis (NEC) is a leading cause of prolonged hospitalizations for premature infants in the United States. In a recent large retrospective study, a significant proportion of NEC cases were shown to occur within 48 hours of packed red blood cell (PRBC) transfusion, especially in growing preterm neonates of older postnatal age. A small body of evidence consistently demonstrates that 25-35 percent of NEC cases are temporally associated with PRBC transfusion and that cases of NEC associated with transfusion are generally more severe with a higher rate of surgical intervention and mortality...
May 2013: Neonatal Network: NN
Amy K Keir, Andrew J McPhee, Chad C Andersen, Michael J Stark
BACKGROUND: Transfusion of packed red blood cells (PRBCs) saves lives in the neonatal critical care setting and is one of the most common interventions in the preterm infant. The number and volume of PRBC transfusions are associated with several major neonatal morbidities, although a direct causal link between transfusion and major neonatal morbidity is still to be proven. Transfusion-related immunomodulation (TRIM) may underlie these adverse outcomes, yet it has received little attention in the high-risk preterm infant...
January 2013: Pediatric Research
Anna Sellmer, Lene Hjelle Tauris, Anders Johansen, Tine Brink Henriksen
AIM: Both patent ductus arteriosus (PDA) and packed red blood cell (PRBC) transfusion are risk factors for necrotizing enterocolitis (NEC). The combination of PDA and PRBC transfusion may have a synergistic effect on the intestinal circulation. METHODS: We present four cases of NEC in very low birth weight (VLBW) infants within 14 h after PRBC transfusion. RESULTS: All infants were growing on full enteral feeding, and they all had a PDA. CONCLUSION: We are concerned that the simultaneous presence of a PDA and PRBC transfusion in VLBW infants may place the infant at even greater risk of NEC than each of these factors alone...
December 2012: Acta Paediatrica
Gowda Parameshwar Prashanth, Mahesh B Maralihalli, Praveen S Bagalkot, Suhas N Joshi
Transfusion-transmitted malaria (TTM) in neonates is rare. TTM can occur in both endemic and nonendemic areas because the current tests used to screen the donor blood for malaria are unreliable when there is low parasitemia. Malaria must be considered as an important differential diagnosis for neonatal sepsis after exchange transfusion. Management strategy in TTM in the neonatal period is not standardized; exchange transfusion is often considered. We used intravenous artesunate in a case of severe malaria caused by Plasmodium vivax in a 30-week preterm neonate after packed red blood cell transfusion on day 19 of life...
September 2012: Pediatrics
Brigit Maria Carter, Diane Holditch-Davis, David Tanaka, Todd A Schwartz
BACKGROUND: Although many therapeutic interventions are necessary for the survival of the preterm infant, understanding the potential effects of these treatments is important to decrease the rate of necrotizing enterocolitis (NEC) in preterm infants. OBJECTIVE: The aim of this study was to examine the relationship between preterm infant treatments administered prior to the development of NEC, specifically the number of packed red blood cell (PRBC) transfusions, weeks of antibiotic therapy for nosocomial infection, and number of mechanical ventilation days, and the development of NEC in preterm infants...
March 2012: Nursing Research
Maurizio Radicioni, Stefania Troiani, Daniele Mezzetti
This prospective observational study conducted in a neonatal intensive care unit aimed to evaluate echocardiographic changes provoked by anemia and transfusion of packed red blood cells (pRBCs) in premature infants. In this study, 32 anemic premature infants had serial echocardiographic assessment of left ventricular (LV) systolic performance, LV preload, and afterload immediately before, within 48 h, and up to 120 h after the transfusion of pRBCs. Pretransfusional evaluations also were compared with similar assessments of 71 nonanemic inpatient premature infants analogous for sex, gestational age at birth, and postnatal age...
April 2012: Pediatric Cardiology
Shira G Fishman, Stephen T Chasen
AIM: To identify factors associated with emergent preterm delivery in women with placenta previa and suspected accreta. METHODS: Pregnancies with placenta previa and ultrasound findings suspicious for accreta were identified. Demographic information and obstetric and neonatal outcomes were obtained from electronic medical records. Mann-Whitney U, Fisher's exact test, and Kaplan-Meier analysis were used. Continuous data are expressed as median (interquartile range)...
November 2011: Journal of Perinatal Medicine
Kiran Kumar Balegar V, Martin Kluckow
OBJECTIVE: To assess the effect of furosemide administered with packed red blood cell transfusion on cardiopulmonary variables of hemodynamically stable, electively transfused preterm infants beyond the first week of life. STUDY DESIGN: A randomized, stratified, double-blind, placebo-controlled trial of intravenous furosemide (1 mg/kg) versus placebo (normal saline) just before "top-up" packed red blood cell transfusion (20 mL/kg over 4 hours) in a tertiary neonatal intensive care unit...
December 2011: Journal of Pediatrics
R Singh, P F Visintainer, I D Frantz, B L Shah, K M Meyer, S A Favila, M S Thomas, D M Kent
OBJECTIVE: To determine association of anemia and red blood cell (RBC) transfusions with necrotizing enterocolitis (NEC) in preterm infants. STUDY DESIGN: A total of 111 preterm infants with NEC ≥ stage 2a were compared with 222 matched controls. In all, 28 clinical variables, including hematocrit (Hct) and RBC transfusions were recorded. Propensity scores and multivariate logistic regression models were created to examine effects on the risk of NEC. RESULT: Controlling for other factors, lower Hct was associated with increased odds of NEC (odds ratio (OR)=1...
March 2011: Journal of Perinatology: Official Journal of the California Perinatal Association
Laura K Fredrickson, Edward F Bell, Gretchen A Cress, Karen J Johnson, M Bridget Zimmerman, Larry T Mahoney, John A Widness, Ronald G Strauss
OBJECTIVE: The safe lower limit of haematocrit or haemoglobin that should trigger a red blood cell (RBC) transfusion has not been defined. The objective of this study was to examine the physiological effects of anaemia and compare the acute responses to transfusion in preterm infants who were transfused at higher or lower haematocrit thresholds. METHODS: The authors studied 41 preterm infants with birth weights 500-1300 g, who were enrolled in a clinical trial comparing high ('liberal') and low ('restrictive') haematocrit thresholds for transfusion...
July 2011: Archives of Disease in Childhood. Fetal and Neonatal Edition
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