Effect of withholding feeds on transfusion-related acute gut injury in preterm infants

a pilot randomized controlled trial

Suzan Sahin, H. Gozde Kanmaz Kutman, Ozlem Bozkurt, Funda Yavanoglu Atay, F. Emre Canpolat, Nurdan Uras, S. Suna Oguz, Mark Underwood

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Several retrospective studies have reported an increase in necrotizing enterocolitis (NEC) during the 48 h following red blood cell (RBC) transfusion. Whether withholding enteral feeding during transfusion decreases the risk of transfusion-associated acute gut injury (TRAGI) in preterm infants is unclear. Study design and methods: In this pilot study, 112 preterm infants with gestational age ≤32 weeks and/or birth weight ≤1500 g were randomly assigned to withholding (NPO) or continuance of feeding (FED) during RBC transfusion. Primary outcome measure was development of NEC (stage ≥ 2) within 72 h of a transfusion and the change in abdominal circumference. Results: One hundred fifty-four transfusion episodes (74 NPO and 80 FED) were analyzed. Demographic characteristics were found to be similar in both groups. There was no difference in rates of NEC (0 versus 3.4%; p =.49) between the NPO and FED groups. The incidence of feeding intolerance was higher in the FED group; however, it was statistically insignificant (1.9 versus 6.8%, p =.36). Abdominal circumference remained similar in both groups in all three consecutive days following transfusion (p>.05). Conclusion: This pilot study does not support withholding feedings during transfusion but is not adequately powered to test the hypothesis that NPO decreases NEC rates. Adequately powered well-designed multicenter trials are still required.

Original languageEnglish (US)
JournalJournal of Maternal-Fetal and Neonatal Medicine
DOIs
StatePublished - Jan 1 2019

Fingerprint

Necrotizing Enterocolitis
Premature Infants
Randomized Controlled Trials
Erythrocyte Transfusion
Wounds and Injuries
Enteral Nutrition
Birth Weight
Gestational Age
Multicenter Studies
Retrospective Studies
Demography
Outcome Assessment (Health Care)
Incidence

Keywords

  • Feeding
  • necrotizing enterocolitis
  • Perfusion Index
  • prematurity
  • TRAGI
  • transfusion
  • transfusion-associated necrotizing enterocolitis (TANEC)
  • withholding feeds

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Effect of withholding feeds on transfusion-related acute gut injury in preterm infants : a pilot randomized controlled trial. / Sahin, Suzan; Gozde Kanmaz Kutman, H.; Bozkurt, Ozlem; Yavanoglu Atay, Funda; Emre Canpolat, F.; Uras, Nurdan; Suna Oguz, S.; Underwood, Mark.

In: Journal of Maternal-Fetal and Neonatal Medicine, 01.01.2019.

Research output: Contribution to journalArticle

Sahin, Suzan ; Gozde Kanmaz Kutman, H. ; Bozkurt, Ozlem ; Yavanoglu Atay, Funda ; Emre Canpolat, F. ; Uras, Nurdan ; Suna Oguz, S. ; Underwood, Mark. / Effect of withholding feeds on transfusion-related acute gut injury in preterm infants : a pilot randomized controlled trial. In: Journal of Maternal-Fetal and Neonatal Medicine. 2019.
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AB - Background: Several retrospective studies have reported an increase in necrotizing enterocolitis (NEC) during the 48 h following red blood cell (RBC) transfusion. Whether withholding enteral feeding during transfusion decreases the risk of transfusion-associated acute gut injury (TRAGI) in preterm infants is unclear. Study design and methods: In this pilot study, 112 preterm infants with gestational age ≤32 weeks and/or birth weight ≤1500 g were randomly assigned to withholding (NPO) or continuance of feeding (FED) during RBC transfusion. Primary outcome measure was development of NEC (stage ≥ 2) within 72 h of a transfusion and the change in abdominal circumference. Results: One hundred fifty-four transfusion episodes (74 NPO and 80 FED) were analyzed. Demographic characteristics were found to be similar in both groups. There was no difference in rates of NEC (0 versus 3.4%; p =.49) between the NPO and FED groups. The incidence of feeding intolerance was higher in the FED group; however, it was statistically insignificant (1.9 versus 6.8%, p =.36). Abdominal circumference remained similar in both groups in all three consecutive days following transfusion (p>.05). Conclusion: This pilot study does not support withholding feedings during transfusion but is not adequately powered to test the hypothesis that NPO decreases NEC rates. Adequately powered well-designed multicenter trials are still required.

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