Transfusion-related Gut Injury and Necrotizing Enterocolitis

• Authors: Allison Rose, Emory University; Vivek Saroha, Emory University; Ravi Patel, Emory University
• Journal Title: CLINICS IN PERINATOLOGY
• Volume: Volume 47, Number 2
• Publisher: W B SAUNDERS CO-ELSEVIER INC | 2020-06-01, Pages 399-+
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.clp.2020.02.002
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Obstetrics & Gynecology; Pediatrics; Preterm; Transfusion; Anemia; Feeding; Morbidity; BLOOD-CELL TRANSFUSIONS; BIRTH-WEIGHT INFANTS; NEAR-INFRARED SPECTROSCOPY; SPLANCHNIC TISSUE OXYGENATION; PRETERM INFANTS; PREMATURE-INFANTS; ANEMIA; ASSOCIATION; CONSUMPTION; THRESHOLDS

Abstract

Necrotizing enterocolitis (NEC) accounts for 10% of deaths in neonatal intensive care units. Several causal mechanisms are likely to lead to a final common disease phenotype. This article summarizes recent data on NEC following red blood cell (RBC) transfusion, with a focus on the most recent literature and ongoing trials. It highlights potential mechanisms from preclinical and human physiologic studies. It also discusses the role of feeding during RBC transfusion and the risk of NEC. Ongoing randomized trials will provide important data on how liberal or conservative approaches to RBC transfusion influence the risk of NEC.