Blood transfusion in patients treated with surgery for necrotizing enterocolitis

Ahmed, Zulfiqar; Danielson, Logan; Albeiruti, Rashad; Thomas, R. J.; Klein, Michael D.

doi:10.1111/pan.12485

Cited by 3 publications

(2 citation statements)

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“…8,9 It has been shown that in patients with severe NEC who underwent bowel resection, preoperative requirement of red blood cell (RBC) transfusions is increased. 10 The relationship between the timing of the transfusion and outcome of NEC has also been under investigation. 9 Some authors have suggested that judicious use of transfusions may diminish the severity of NEC.…”

Section: Introductionmentioning

confidence: 99%

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The Outcome of Blood Transfusions in Conservative and Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation

Karila

Koivusalo

2020

Eur J Pediatr Surg

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Introduction In necrotizing enterocolitis (NEC), blood transfusions (BTs) are a disputed factor concerning the etiology and the outcome. We assessed retrospectively the effects of preonset BT on the outcome of NEC and spontaneous intestinal perforation (SIP). Materials and Methods With ethical consent, we reviewed the hospital records of 113 neonates from 2002 to 2019 with surgical NEC (NECs) (n = 57), conservatively treated NEC (NECc) (n = 20), and SIP (n = 36). The onset was defined as the day of surgery (NECs and SIP) or diagnosis (NECc). The effects of preonset BT (total, beyond 48 hours, and within 48 hours) were compared with the effects of birth weight (BW), gestational age (GA), intracerebral hemorrhage, respiratory distress syndrome, septicemia, and patent ductus arteriosus. Main outcome measure was 2-week mortality, and secondary measures were small intestinal loss and days on parenteral nutrition (PN). Results Overall mortality (8.9%) was predicted independently by BT total and BT beyond 48 hours, risk ratio (RR) = 1.1 to 1.2 (95% confidence interval [CI] = 1.0–1.4), p = 0.01 to 0.02, and BW and GA, RR = 0.7 to 1.0 (95% CI = 0.5–1.0), p = 0.02 to 0.04. Mortality in NECs (12%) was predicted by BT total and BT beyond 48 hours only, RR = 1.1 to 1.2 (95% CI = 1.0–1.5), p = 0.03 to 0.04. BT within 48 hours of onset did not predict mortality. No factors were related with secondary outcome measures or with mortality in patients with SIP or NECc. Conclusion In NECs, preoperative BT and BT given more than 48 hours before surgery were correlated with slightly increased 2-week mortality but not with small intestinal loss or duration of PN.

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Section: Introductionmentioning

confidence: 99%

“…8 9 It has been shown that in patients with severe NEC who underwent bowel resection, preoperative requirement of red blood cell (RBC) transfusions is increased. 10…”

Section: Introductionmentioning

confidence: 99%