极低出生体重儿输注红细胞悬液后发生坏死性小肠结肠炎的风险。
Risk of Necrotizing Enterocolitis Following Packed Red Blood Cell Transfusion in Very Low Birth Weight Infants.
机构信息
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, 15, Kanjanavanit Raod, Tambon Korhong, Hat Yai District, Songkhla, 90110, Thailand.
The Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai District, Songkhla, Thailand.
出版信息
Indian J Pediatr. 2019 Apr;86(4):347-353. doi: 10.1007/s12098-019-02887-7. Epub 2019 Feb 21.
OBJECTIVE
To evaluate the association between red blood cell (RBC) transfusion leading to necrotizing enterocolitis (NEC) within 48 h, known as transfusion-associated necrotizing enterocolitis (TANEC).
METHODS
A nested case-control study using historical data was conducted in the neonatal intensive care unit of Songklanagarind Hospital, Thailand. All very low birth weight (VLBW) infants delivered between November 2009 and July 2016 were enrolled. The infants were identified as RBC transfusion received and NEC developed. Logistic regression was used to evaluate risk factors for transfusion and the association between RBC transfusion and NEC.
RESULTS
Four hundred and forty-four VLBW infants were enrolled in the study. The median (interquartile range) gestational age was 29 (27, 31) wk. The overall incidence of NEC was 13%. Three (5.2%) of the NEC infants had TANEC. The infants who received RBC transfusion had a lower gestational age [odds ratio, OR 0.64; 95% confidence interval (95%CI) 0.57, 0.73, p < 0.001] and were more likely to have pneumonia (OR 9.86; 95%CI 5.02, 19.35, p < 0.001) or to have received H blocker (OR 2.92; 95%CI 1.73, 4.93, p < 0.001). The ORs (95% CI) after adjusting for confounders, the association between RBC transfusion and NEC for transfusions ≤2 d, >2 to 4 d, and > 4 to 6 d prior to NEC were 1.83 (0.41, 8.16; p = 0.43), 1.7 (0.26, 11.16; p = 0.58) and 1.19 (0.31, 4.62; p = 0.80) respectively.
CONCLUSIONS
After controlling of confounders, no evidence of association was found between RBC transfusion and TANEC.
目的
评估红细胞（RBC）输血导致坏死性小肠结肠炎（NEC）的关联，即输血相关性坏死性小肠结肠炎（TANEC）。
方法
在泰国宋卡王子大学医院的新生儿重症监护病房进行了一项使用历史数据的嵌套病例对照研究。所有极低出生体重（VLBW）婴儿均于 2009 年 11 月至 2016 年 7 月间分娩。婴儿被识别为接受 RBC 输血并发生 NEC。采用 logistic 回归评估输血的危险因素以及 RBC 输血与 NEC 之间的关系。
结果
共纳入 444 名 VLBW 婴儿。中位（四分位间距）胎龄为 29（27，31）周。NEC 的总体发生率为 13%。3 名（5.2%）NEC 婴儿发生 TANEC。接受 RBC 输血的婴儿胎龄较低[比值比（OR）0.64；95%置信区间（95%CI）0.57，0.73，p<0.001]，且更有可能患有肺炎（OR 9.86；95%CI 5.02，19.35，p<0.001）或接受 H 阻滞剂（OR 2.92；95%CI 1.73，4.93，p<0.001）。调整混杂因素后，NEC 前≤2 d、>2-4 d 和>4-6 d 时 RBC 输血与 NEC 的 OR（95%CI）分别为 1.83（0.41，8.16；p=0.43）、1.7（0.26，11.16；p=0.58）和 1.19（0.31，4.62；p=0.80）。
结论
在控制混杂因素后，RBC 输血与 TANEC 之间没有关联的证据。
Zotero 插件