Document Detail

Transfusion-related acute gut injury: necrotizing enterocolitis in very low birth weight neonates after packed red blood cell transfusion.
MedLine Citation:
PMID:  21067771     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This is a repeat cohort study in which we sought to determine whether an association of necrotizing enterocolitis (NEC) <48 hours of a packed red blood cells (PRBC) transfusion was a prior sampling artifact.
STUDY DESIGN: All very low birth weight neonates with NEC Stage ≥ IIB admitted over an 18-month period were categorized for NEC: (1) <48 hours after a PRBC transfusion; (2) unrelated to the timing of PRBCs; and (3) never transfused.
RESULTS: Eight hundred eighty-three admissions over 18 months were reviewed; 256 were very low birth weight that resulted in 36 NEC cases and 25% were associated with PRBC (n = 9). PRBC-associated cases had lower birth weight, hematocrit, and rapid onset of signs (<5 hours). The timing of association of PRBC transfusion and NEC differed from random, showing a distribution that was not uniform over time (χ(2) = 170.7, df = 40; P < .000001) consistent with the possibility of a causative relationship in certain cases of NEC. Current weight at onset of NEC did not differ; however, the more immature the neonate the later the onset of NEC creating a curious centering of occurrence at a median of 31 weeks postconceptual age.
CONCLUSIONS: We conclude that PRBC-related NEC exists. Transfusion-related acute gut injury is an acronym we propose to characterize a severe neonatal gastrointestinal reaction proximal to a transfusion of PRBCs for anemia. The convergence at 31 weeks postconceptual age approximates the age of presentation of other O(2) delivery and neovascularization syndromes, suggesting a link to a generalized systemic maturational mechanism.
Jonathan Blau; Johanna M Calo; Donna Dozor; Millicent Sutton; Gad Alpan; Edmund F La Gamma
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2010-11-10
Journal Detail:
Title:  The Journal of pediatrics     Volume:  158     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-14     Completed Date:  2011-04-05     Revised Date:  2012-05-29    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  403-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
Regional Neonatal Intensive Care Unit, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY 10595, USA.
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MeSH Terms
Enterocolitis, Necrotizing / epidemiology,  etiology*
Erythrocyte Transfusion / adverse effects*
Infant, Newborn
Infant, Very Low Birth Weight*
Linear Models
New York / epidemiology
Retrospective Studies
Risk Factors
Time Factors
Comment In:
J Pediatr. 2011 Oct;159(4):701-2; author reply 702-3   [PMID:  21784439 ]
J Pediatr. 2011 Aug;159(2):354-5; author reply 355-6   [PMID:  21592509 ]
J Pediatr. 2012 Feb;160(2):354; author reply 354-5   [PMID:  22082949 ]
J Pediatr. 2012 May;160(5):887; author reply 887-8   [PMID:  22316626 ]
J Pediatr. 2011 Mar;158(3):349-50   [PMID:  21146187 ]

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