Necrotizing enterocolitis is an intestinal disease prevalent amongst infants resulting from the death of cells in the small and or large intestines. Many researchers have attempted to define a relationship between red blood cell transfusion and anemia to nectrozing enterocolitis; however, these relationships have been poorly defined and studies have presented with conflicting information. To that end, the researchers of this study aspired to conduct a more comprehensive analysis of the potential relationship.
In a study period lasting from January 2010 to February 2014, 598 very low birth weight infants were evaluated after having been admitted to level 3 neonatal care units in Atlanta, Georgia within 5 days of birth. Infants were evaluated through 90 days, until they were either discharged from the care unit, moved to a non-study facility, or passed away. The main endpoint that the researchers looked at was the development of necrotizing enterocolitis based on a primary exposure to red blood cell transfusion and a secondary exposure to severe anemia.
Ultimately, the researchers concluded that red blood cell transfusion was not significantly correlated with the development of necrotizing enterocolitis. However, the researchers did conclude that there was a significant correlation and increase in severe anemia and necrotizing enterocolitis.
From a clinical standpoint, moving forward, the researchers addressed the need for further studies concerning these relationships. In doing so, we will gain more evidence for improving therapeutic outcomes for these infants by implementing systematic methods of care, for example, no longer avoiding the use of red blood cell transfusions simply for the sake of fear of inducing necrotizing enterocolitis.
Patel RM, Knezevic A, Shenvi N et al. Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocolitis in Very Low-Birth-Weight Infants. JAMA. 2016;315(9):889-97.