Brits E, Kruger I, Joubert G
Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
South Afr J Crit Care. 2024 Jul 17;40(2):e1108. doi: 10.7196/SAJCC.2024.v40i2.1108. eCollection 2024.
Necrotising enterocolitis (NEC) is life-threatening with a rising incidence due to improved neonatal care. While researchers' focus has shifted to causes, risk factors and preventative clinical strategies, little is known about the exact aetiology of NEC. Risk factors include the relationship between red blood cell transfusions (RBCTs) and the development of transfusion-associated NEC (TANEC) and peri-transfusion feeding, increasing the risk of TANEC.
Evaluate the relationship between RBCT and peri-transfusion feeding practices and the development of TANEC in very low birthweight (VLBW) neonates over 5 years.
This was a retrospective analytical record review of all VLBW neonates admitted to two tertiary hospitals' neonatal units in Bloemfontein, South Africa (SA), from 1 January 2012 - 31 December 2016.
The study population (n=1 426) had a median birthweight of 1 260 g and a median gestation age of 30 weeks. RBCTs were given to 41.9%, and NEC developed in 7.4%, of whom 47.6% had an RBCT (TANEC). Half (47.2%) were kept nil per os (NPO) around the transfusion. No association was found between NPO status and TANEC development (8.9% NPO patients, 7.9% non-NPO patients, p=0.6826). No significant differences regarding Modified Bell's Staging were found between neonates who developed TANEC v. NEC.
Optimising the administration of RBCTs and evidence-based feeding protocols is crucial in reducing TANEC's impact on premature neonates.
The study examines the link between red blood cell transfusion and transfusion-associated necrotising enterocolitis in very low birthweight neonates. It highlights the need for evidence-based feeding protocols to reduce transfusion-associated necrotising enterocolitis risk during transfusions. It calls for standardised clinical guidelines to improve neonatal outcomes and lower necrotising enterocolitis and transfusion-associated necrotising enterocolitis incidence.
坏死性小肠结肠炎（NEC）危及生命，由于新生儿护理水平提高，其发病率呈上升趋势。尽管研究人员的重点已转向病因、风险因素和预防性临床策略，但对NEC的确切病因知之甚少。风险因素包括红细胞输血（RBCT）与输血相关NEC（TANEC）的发生之间的关系以及输血期间的喂养，这会增加TANEC的风险。
评估5年间极低出生体重（VLBW）新生儿中RBCT与输血期间喂养方式和TANEC发生之间的关系。
这是一项对2012年1月1日至2016年12月31日期间入住南非布隆方丹两家三级医院新生儿科的所有VLBW新生儿进行的回顾性分析记录审查。
研究人群（n = 1426）的中位出生体重为1260g，中位胎龄为30周。41.9%的新生儿接受了RBCT，7.4%的新生儿发生了NEC，其中47.6%接受了RBCT（TANEC）。一半（47.2%）的新生儿在输血期间禁食（NPO）。未发现NPO状态与TANEC发生之间存在关联（NPO患者为8.9%，非NPO患者为7.9%，p = 0.6826）。发生TANEC的新生儿与发生NEC的新生儿在改良贝尔分期方面未发现显著差异。
优化RBCT的输注及循证喂养方案对于降低TANEC对早产新生儿的影响至关重要。
该研究探讨了极低出生体重新生儿红细胞输血与输血相关坏死性小肠结肠炎之间的联系。强调了需要循证喂养方案以降低输血期间输血相关坏死性小肠结肠炎的风险。呼吁制定标准化临床指南以改善新生儿结局并降低坏死性小肠结肠炎和输血相关坏死性小肠结肠炎的发病率。
