Analysis of the association between necrotizing enterocolitis and transfusion of red blood cell in very low birth weight preterm infants

Bak, Seon-Yeong; Lee, Sihyoung; Park, Jae-Hong; Park, Kyu-Hee; Jeon, Ji-Hyun

The NEC diagnosis was made according to the modified Bell's staging criteria by a neonatologist when infants had both systemic and radiographic signs of NEC. Infants with stage II or greater were defined as the NEC group and those less than stage II and without NEC patients were defined as the control group. We defined that RBC(t) before NEC diagnosis as the frequency of transfusion until the NEC diagnosis (mean day at NEC diagnosis, day 18) in NEC group. Therefore, the frequency of transfusion was counted until 18 days after birth in control group. We evaluated patient history, including GA, birth weight (B.wt), Apgar score at 1 and 5 minutes, hemoglobin (Hgb) and hematocrit (Hct) at birth, the time from premature rupture of membrane (PROM), the use of prenatal antibiotics, intraventicular hemorrhage (IVH≥grade 2: identified and classi fied by sonographic features), disseminated intravascular coagulopathy (DIC), hemorrhage history at other sites (pulmonary hemorrhage, gastrointestinal hemorrhage, and petechia), the presence of respiratory distress syndrome (RDS), and the number of times surfactant was used, presence of patent ductus arteriosus (PDA), dose of indomethacin admini stration, time on ventilator and O 2 and the presence of bron chopulmonary dysplasia. We investigated the NEC stage and the frequency of packed RBC(t) during the hospital course and transfusions before the NEC diagnosis for the patients with a NEC diagnosis. The decision for RBC(t) was made by the neonatologist caring for the infant and transfusion guidelines 11) were followed. All transfusions were done with packed RBCs. Packed RBCs were transfused in a volume of 10 to 20 mL/kg over 2 to 4 hours.