Implementation of a peri-transfusion fasting protocol in necrotizing enterocolitis, in Colombian newborns
Keywords:
Necrotizing enterocolitis, blood transfusion, food, prematurity and low birth weight.Abstract
Objective: Determine the difference in incidence of transfusion-associated necrotizing enterocolitis in preterm newborns with and without implementation of a peri-transfusion fasting protocol.
Methods: Retrospective observational study. All preterm newborns that were transfused with red blood cell units during the period from July 2015 to October 2016 in the newborns´ unit at a third level of care center in Colombia were included. The peri-transfusion fasting protocol started on April 2016. Transfusion-associated necrotizing enterocolitis was defined as necrotizing enterocolitis presented within 48 hours after the transfusion. Demographic variables, feeding, number of transfusions and variables associated with necrotizing enterocolitis were analyzed.
Results: During the study time, 148 premature newborns needed at least one transfusion of red blood cells that accounted for 385 transfusion events. Seven cases of transfusion-associated necrotizing enterocolitis were reported. The overall cumulative incidence was 4.7% (3.6% with peri-transfusion fasting protocol and 6.3% without protocol), the overall incidence rate of transfusion-associated necrotizing enterocolitis was 18/1000 people-transfusion (IC 95% 7–37/1000 people-transfusion); it was higher in the group without protocol (28/1000 people-transfusion) than in the group with protocol (12/1000 people-transfusion), but without statistical significance.
Conclusions: Implementation of the peri-transfusion fasting protocol may decrease the incidence and severity of necrotizing enterocolitis associated with transfusion. Prospective studies are required to establish the relationship between enteral feeding during transfusion and necrotizing enterocolitis.
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