Dataset Information

Impact of red blood cell transfusions on intestinal barrier function in preterm infants.

ABSTRACT:

Objective

To determine the relationships of red blood cell (RBC) transfusion and enteral feeding to changes in intestinal permeability (IP) measured by the relative intestinal uptake of lactulose (La) and rhamnose (Rh) in preterm infants?<33 wk gestation.

Design/methods

Infants 240-326wk gestation received La/Rh solution enterally on study days 1, 8 and 15.Urinary La/Rh ratio was measured by HPLC. Hematocrit preceding transfusion, total RBC transfusion volume, volume/kg, and feeding status during each study interval (birth-d1; d1-d8, and d8-d15) were determined.

Results

Of the seventeen (40.5%) subjects who received?1 transfusion during the study period, 12 (70.6%) infants were?<28 wk gestation and 5 (29.4%) infants were?28 wk gestation, p??0.05) than in intervals preceding low IP (La/Rh?0.05) measurements (33 vs 35.8, p?=?0.1051). RBC transfusions occurred more frequently in intervals preceding high IP than in intervals preceding low IP (26.8%; vs 8.3%, p?=?0.0275) with 5-fold higher total RBC volume and volume/kg in intervals preceding any time point with high IP. RBC transfusion during an interval was associated with a three-fold increased risk of high IP (aOR 2.7; 95% C.I 0.564-12.814; p?=?0.2143). Exclusive breast milk exposure and post-menstrual age reduced the risk for high IP following RBC transfusion.

Conclusions

Both RBC transfusion number and volume was associated with subsequent high IP measurements in preterm infants?<33 weeks gestation and potentially may contribute to impairment of the preterm intestinal barrier.

SUBMITTER: Ajayi OO

PROVIDER: S-EPMC7891311 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Impact of red blood cell transfusions on intestinal barrier function in preterm infants.

Ajayi O O OO Davis N L NL Saleem B B Kapoor S S Okogbule-Wonodi A C AC Viscardi R M RM Sundararajan Sripriya S

Journal of neonatal-perinatal medicine 20190101 1

<h4>Objective</h4>To determine the relationships of red blood cell (RBC) transfusion and enteral feeding to changes in intestinal permeability (IP) measured by the relative intestinal uptake of lactulose (La) and rhamnose (Rh) in preterm infants <33 wk gestation.<h4>Design/methods</h4>Infants 240-326wk gestation received La/Rh solution enterally on study days 1, 8 and 15.Urinary La/Rh ratio was measured by HPLC. Hematocrit preceding transfusion, total RBC transfusion volume, volume/kg, and feedi ...[more]

PMID: 30412507

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Project description:Background: Anemia remains a common comorbidity of preterm infants in the neonatal intensive care unit (NICU). Left untreated, severe anemia may adversely affect organ function due to inadequate oxygen supply to meet oxygen requirements, resulting in hypoxic tissue injury, including cerebral tissue. To prevent hypoxic tissue injury, anemia is generally treated with packed red blood cell (RBC) transfusions. Previously published data raise concerns about the impact of anemia on cerebral oxygen delivery and, therefore, on neurodevelopmental outcome (NDO). Objective: To provide a systematic overview of the impact of anemia and RBC transfusions during NICU admission on cerebral oxygenation, measured using near-infrared spectroscopy (NIRS), brain injury and development, and NDO in preterm infants. Data Sources: PubMed, Embase, reference lists. Study Selection: We conducted 3 different searches for English literature between 2000 and 2020; 1 for anemia, RBC transfusions, and cerebral oxygenation, 1 for anemia, RBC transfusions, and brain injury and development, and 1 for anemia, RBC transfusions, and NDO. Data Extraction: Two authors independently screened sources and extracted data. Quality of case-control studies or cohort studies, and RCTs was assessed using either the Newcastle-Ottawa Quality Assessment Scale or the Van Tulder Scale, respectively. Results: Anemia results in decreased oxygen-carrying capacity, worsening the burden of cerebral hypoxia in preterm infants. RBC transfusions increase cerebral oxygenation. Improved brain development may be supported by avoidance of cerebral hypoxia, although restrictive RBC transfusion strategies were associated with better long-term neurodevelopmental outcomes. Conclusions: This review demonstrated that anemia and RBC transfusions were associated with cerebral oxygenation, brain injury and development and NDO in preterm infants. Individualized care regarding RBC transfusions during NICU admission, with attention to cerebral tissue oxygen saturation, seems reasonable and needs further investigation to improve both short-term effects and long-term neurodevelopment of preterm infants.

Dataset Information

Impact of red blood cell transfusions on intestinal barrier function in preterm infants.

Objective

Design/methods

Results

Conclusions

Publications

Impact of red blood cell transfusions on intestinal barrier function in preterm infants.

Similar Datasets

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