Transfusion Associated Necrotising Enterocolitis

Abstract

Necrotizing enterocolitis (NEC) remains one of the most common neonatal morbidities with an incidence of about 9% and mortality rates of 20-30% in extremely preterm infants. Various pathophysiological pathways have been proposed for the development of NEC; the exact mechanism still remains elusive. There has been a recent controversy about the association between packed red blood cell (pRBC) transfusion and development of acute gut injury with clinical manifestations similar to NEC. The interaction between transfusion and gut injury known as transfusion associated gut injury (TRAGI) or transfusion associated NEC (TANEC). Reperfusion injury caused by transfusion in a hypoxic gut has been speculated as one of the pathogenic mechanisms of TRAGI. Feeding an infant during transfusion can aggravate this insult by further increasing the oxygen demand. The aim of this study is to investigate the effect of different feeding strategies applied during erythrocyte transfusion on feeding intolerance and TR-NEC development in premature infants.