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Review
. 2019 Mar;46(1):101-117.
doi: 10.1016/j.clp.2018.09.006. Epub 2018 Dec 12.

Epidemiology of Necrotizing Enterocolitis: New Considerations Regarding the Influence of Red Blood Cell Transfusions and Anemia

Vivek Saroha  1 , Cassandra D Josephson  2 , Ravi Mangal Patel  3
Affiliations
Review

Epidemiology of Necrotizing Enterocolitis: New Considerations Regarding the Influence of Red Blood Cell Transfusions and Anemia

Vivek Saroha et al. Clin Perinatol. 2019 Mar.

Abstract

This article summarizes available evidence on the relationship between red blood cell transfusion and anemia, and necrotizing enterocolitis (NEC). We review recent studies that highlight the uncertainty of the effect of red blood cell transfusion on NEC and the potential role of anemia. We also discuss potential pathophysiologic effects of both red blood cell transfusion and anemia and highlight strategies to prevent anemia and red blood cell transfusion. We also discuss ongoing randomized trials that are likely to provide important new evidence to guide red blood cell transfusion practices.

Keywords: Blood; Infant; Morbidity; Neonate; Oxygenation; Preterm.

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Conflict of interest statement

Conflicts of interest: Dr. Josephson has received oxygenation monitoring equipment (e.g. NIRS and pulse oximetry) from Medtronic, Inc. The company had no role in this review. The other authors have no conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Potential mechanisms for the pathogenesis of intestinal injury from anemia and RBC transfusion. Abbreviations: NEC, Necrotizing Enterocolitis; ET1, Endothelin 1; NO, Nitric Oxide; TLR-4, Toll-like receptor 4; Th, T helper cell
See this image and copyright information in PMC

References

    1. Stoll BJ, Hansen NI, Bell EF, et al. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. Jama. 2015;314(10):1039–1051. - PMC - PubMed
    1. Jacob J, Kamitsuka M, Clark RH, Kelleher AS, Spitzer AR. Etiologies of NICU deaths. Pediatrics. 2015;135(1):e59–65. - PubMed
    1. Horbar JD, Edwards EM, Greenberg LT, et al. Variation in performance of neonatal intensive care units in the united states. JAMA Pediatrics. 2017;171(3):e164396. - PubMed
    1. Battersby C, Santhalingam T, Costeloe K, Modi N. Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review. Archives of disease in childhood Fetal and neonatal edition. 2018;103(2):F182–f189. - PubMed
    1. La Gamma EF, Blau J. Transfusion-related acute gut injury: feeding, flora, flow, and barrier defense. Seminars in perinatology. 2012;36(4):294–305. - PubMed

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