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Influence of Shielding Total Parenteral Nutrition From Photooxidation On The Number of Early Blood Transfusions In Extremely Low Birthweight Premature Neonates.
MedLine Citation:
PMID:  22487951     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES:: The smallest premature neonates often receive blood transfusions early in life. Non-restrictive transfusion policies are linked to deleterious outcomes. Exposure of TPN to ambient light (LE) generates oxidation products associated with haemolysis in vitro. Shielding TPN from light (LP) limits oxidation. Hypothesis: protecting TPN from light decreases haemolysis and therefore the need for early blood transfusions. METHODS:: Comparison of haemolysis between animals fed enterally and those receiving TPN, and exploratory case control retrospective analysis of transfusion counts in premature infants receiving LE or LP TPN. Statistical analysis: ANOVA and longitudinal binomial regression model adjusting for potential covariables of transfusion counts. RESULTS:: In animals: TPN is associated with higher (p < 0.05) haemolysis compared to enteral feeds; photoprotection induces lower peroxide load with no effect on level of haemolysis. In premature infants: LE (n=76) or LP (n = 57) populations exhibited similar clinical characteristics. Initial hematocrit, gestational age and index of disease severity had a significant effect on the number of transfusions. When adjusting for these covariables photoprotection was no longer significant. CONCLUSION:: Even though peroxides are associated in vitro with haemolysis, shielding TPN fom light to reduce infused peroxides does not significantly decrease the need for early transfusions in premature infants.
Authors:
Amélie Stritzke; Valérie Turcot; Thérèse Rouleau; Jean-Claude Lavoie; Philippe Chessex
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-6
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Division of Neonatology, Departments of Pediatrics, Children's and Women's Health Center of BC, Vancouver †Research Center Hospital Ste-Justine, Montreal, QC ‡Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada.
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