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Red blood cell transfusions in the newborn

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By Barbara Aninakwa Advance Neonatal Nurse Practitioner
Deepak Sharma, Sweta Shastri
Neonatal sepsis and necrotizing enterocolitis (NEC) are two most important neonatal problems in nursery which constitute the bulk of neonatal mortality and morbidity. Inflammatory mediators secondary to sepsis and NEC increases morbidity, by affecting various system of body like lung, brain and eye, thus causing long term implications. Lactoferrin (LF) is a component of breast milk and multiple actions that includes antimicrobial, antiviral, anti-fungal and anti-cancer and various other actions. Few studies have been completed and a number of them are in progress for evaluation of efficacy and safety of LF in the prevention of neonatal sepsis and NEC in field of neonatology...
March 2016: Journal of Maternal-fetal & Neonatal Medicine
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
Erin Geary
Infants exposed to absent or reversed end-diastolic flow (ARE DF) in utero may be at an increased risk of developing necrotizing enterocolitis (NEC). This article reviews placental function and the development of ARE DF. Studies examining the relationship between AREDF and NEC are reviewed, yet research remains inconclusive regarding this relationship. Recent studies reveal that early minimal enteral feeding does not increase the incidence of NEC in infants with AREDF. Initiation and advancement of enteral feedings should be monitored closely in this subset of the neonatal intensive care unit (NICU) population...
January 2013: Neonatal Network: NN
E G Abu Jawdeh, R J Martin, T E Dick, M C Walsh, J M Di Fiore
OBJECTIVE: To test the hypothesis that the effect of red blood cell (RBC) transfusion on intermittent hypoxemia (IH) in extremely low birth weight (ELBW) infants is dependent on postnatal age. STUDY DESIGN: Oxygen saturation of 130 ELBW infants, who required transfusion, was monitored continuously for the first 8 weeks of life. We compared the characteristics of IH (SpO2⩽80% for ⩾4 s and ⩽3 min), 24 h before and both 24 h and 24 to 48 h after each RBC transfusion at three distinct time periods: Epoch 1, 1 to 7 days; Epoch 2, 8 to 28 days; and Epoch 3, >28 days...
December 2014: Journal of Perinatology: Official Journal of the California Perinatal Association
F Gómez Martín, M Sáenz de Pipaón, J Pérez Rodríguez, J Quero Jiménez
AIM: To determine risk or protective factors for the development of necrotizing enterocolitis in very low birth weight infants. METHODS: This retrospective case-control study was conducted at La Paz University Hospital including infants with a birth weight of <1500 g for three years. Cases with confirmed diagnosis of necrotizing enterocolitis were evaluated; each one was paired with a control infant of the same gestational age. Statistical analysis included unadjusted and multivariable analyses...
January 1, 2013: Journal of Neonatal-perinatal Medicine
Bahubali Gane, B Vishnu Bhat, B Adhisivam, Rojo Joy, P Prasadkumar, P Femitha, B Shruti
OBJECTIVES: To analyze multiple risk factors of necrotizing enterocolitis (NEC) and the outcome. METHODS: Hundred neonates with NEC were compared with 100 normal neonates matched for sex, gestation and weight. Their data including antenatal, natal, course of illness, hospital stay, progress and outcome were collected. Univariate analysis and logistic regression were used to analyze the risk factors. RESULTS: Mean age of onset of NEC was 2...
May 2014: Indian Journal of Pediatrics
Nigel J Hall, Simon Eaton, Agostino Pierro
Necrotizing enterocolitis (NEC) remains a very serious disease, particularly in premature infants. This review describes various aspects of the diagnosis and treatment of the disease. The pathogenesis of NEC is not completely understood, and risk factors include formula enteral feeding and bacterial involvement. Prevention of the disease is desirable, and the most robust evidence is linked to the protective effet of human milk and probiotics. The medical and surgical management has not changed significantly in the last 20 years...
December 2013: Journal of Pediatric Surgery
Isabelle M C Ree, Vivianne E H J Smits-Wintjens, Esther G J Rijntjes-Jacobs, Iris C M Pelsma, Sylke J Steggerda, Frans J Walther, Enrico Lopriore
BACKGROUND: Small for gestational age (SGA) neonates are at increased risk of mortality and morbidity, including necrotizing enterocolitis (NEC), but detailed information on the incidence and risk factors of NEC in SGA neonates is lacking. OBJECTIVE: This study aims to estimate the incidence of NEC in a large cohort of SGA neonates, compared to appropriate for gestational age (AGA) neonates. METHODS: We included all SGA neonates without congenital malformations admitted to our neonatal nursery between 2004 and 2013...
2014: Neonatology
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
Jae H Kim
Necrotizing enterocolitis (NEC) continues to be the most severe gastrointestinal emergency facing the preterm neonate. The pathogenesis of NEC is still a complex and poorly understood process, but with increasing understanding of the role of enteral feeding, gut immunity and the altered gut microbiota, new opportunities to reduce overall NEC rates are now possible. Prevention strategies continue to lead as the most suitable approaches to reducing NEC, as early diagnosis and rapid effective treatment of NEC are still not optimal...
February 2014: Seminars in Fetal & Neonatal Medicine
R Parige, C Turner, S Sundaram, S Power
No abstract text is available yet for this article.
March 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
Robert D Christensen, Vickie L Baer, Antonio Del Vecchio, Erick Henry
Red blood cell transfusions can be life-saving for neonates with severe anemia or active hemorrhage. However, risks of transfusions exist and should always be weighed against potential benefits. At least two transfusion risks are unique to very low birth weight neonates. The first is an association between transfusions given in the first days after birth and the subsequent occurrence of a grade 3 or 4 intraventricular hemorrhage. The second is an association between "late" RBC transfusions and the subsequent occurrence of necrotizing enterocolitis...
October 2013: Journal of Maternal-fetal & Neonatal Medicine
(no author information available yet)
No abstract text is available yet for this article.
October 2013: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Leslie A Parker
Necrotizing enterocolitis (NEC) is a disease affecting premature infants with potentially devastating complications in the neonatal intensive care unit (NICU). Inadequate knowledge regarding the underlying pathophysiology of this disease has contributed to the minimal progress made in decreasing the incidence and severity of NEC. Because of an improved survival rate of the most immature infants, the number of diagnosed cases of NEC is anticipated to increase. Unfortunately, decades of research have failed to reduce the risk or improve the prognosis of NEC, magnifying the need for risk-reduction strategies for decreasing significant NEC-related morbidity and mortality...
October 2013: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Stephanie Papillon, Shannon L Castle, Christopher P Gayer, Henri R Ford
No abstract text is available yet for this article.
2013: Advances in Pediatrics
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
Hui-Kang Tao, Qin Tang, Ming-Yan Hei, Bo Yu
OBJECTIVE: To quantitatively assess the association between transfusions and the risk of necrotizing enterocolitis (NEC) in neonates. METHOD: Both Chinese and English literature published from Jan. 1985 to Nov. 2011 about the case-control study of the association between transfusions and neonatal NEC were retrieved by searching the electronic resource databases. A meta-analysis was then performed on the comparison and synthesis of findings from included studies...
May 2013: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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
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
2014-05-19 13:06:27
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