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Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis.

Publication ,  Journal Article
Derienzo, C; Smith, PB; Tanaka, D; Bandarenko, N; Campbell, ML; Herman, A; Goldberg, RN; Cotten, CM
Published in: Early Hum Dev
May 2014

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. We compared demographic and laboratory data for TANEC vs. other NEC infants and the incidence of TANEC pre/post implementation of our peri-transfusion feeding protocol. We also assessed the relationship between pre-transfusion hematocrit and pRBC unit age with TANEC. RESULTS: A total of 148/1380 (10.7%) infants developed NEC. Incidence of NEC decreased after initiating our peri-transfusion feeding protocol: 126/939 (12%) to 22/293 (7%), P=0.01. The proportion of TANEC did not change: 51/126 (41%) vs. 9/22 (41%), P>0.99. TANEC infants were smaller, more likely to develop surgical NEC, and had lower mean pre-transfusion hematocrits prior to their TANEC transfusions compared with all other transfusions before their NEC episode: 28% vs. 33%, P<0.001. Risk of TANEC was inversely related to pre-transfusion hematocrit: odds ratio 0.87 (0.79-0.95). CONCLUSIONS: Pre-transfusion hematocrit is inversely related to risk of TANEC, which suggests that temporally maintaining a higher baseline hemoglobin in infants most at risk of NEC may be protective. The lack of difference in TANEC pre-/post-implementation of our peri-transfusion feeding protocol, despite an overall temporal decrease in NEC, suggests that other unmeasured interventions may account for the observed decreased incidence of NEC.

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Published In

Early Hum Dev

DOI

EISSN

1872-6232

Publication Date

May 2014

Volume

90

Issue

5

Start / End Page

237 / 240

Location

Ireland

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Newborn
  • Humans
  • Hematocrit
  • Gestational Age
 

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Derienzo, C., Smith, P. B., Tanaka, D., Bandarenko, N., Campbell, M. L., Herman, A., … Cotten, C. M. (2014). Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis. Early Hum Dev, 90(5), 237–240. https://doi.org/10.1016/j.earlhumdev.2014.02.003
Derienzo, Chris, P Brian Smith, David Tanaka, Nicholas Bandarenko, Mary Lee Campbell, Annadele Herman, Ronald N. Goldberg, and C Michael Cotten. “Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis.Early Hum Dev 90, no. 5 (May 2014): 237–40. https://doi.org/10.1016/j.earlhumdev.2014.02.003.
Derienzo C, Smith PB, Tanaka D, Bandarenko N, Campbell ML, Herman A, et al. Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis. Early Hum Dev. 2014 May;90(5):237–40.
Derienzo, Chris, et al. “Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis.Early Hum Dev, vol. 90, no. 5, May 2014, pp. 237–40. Pubmed, doi:10.1016/j.earlhumdev.2014.02.003.
Derienzo C, Smith PB, Tanaka D, Bandarenko N, Campbell ML, Herman A, Goldberg RN, Cotten CM. Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis. Early Hum Dev. 2014 May;90(5):237–240.
Journal cover image

Published In

Early Hum Dev

DOI

EISSN

1872-6232

Publication Date

May 2014

Volume

90

Issue

5

Start / End Page

237 / 240

Location

Ireland

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Newborn
  • Humans
  • Hematocrit
  • Gestational Age