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Feeding Practices and Effects on Transfusion-Associated Necrotizing Enterocolitis in Premature Neonates.

医学 坏死性小肠结肠炎 肠内给药 肠外营养 新生儿重症监护室 儿科 小肠结肠炎 胎龄 重症监护医学 重症监护 新生儿学 败血症
作者
Emma Killion
出处
期刊:Advances in Neonatal Care [Ovid Technologies (Wolters Kluwer)]
卷期号:21 (5): 356-364 被引量:1
标识
DOI:10.1097/anc.0000000000000872
摘要

Background Red blood cell (RBC) transfusions have been implicated in the development of enterocolitis (NEC) in premature infants. Some evidence exists to support that withholding feedings during transfusion reduces the risk of subsequent NEC development. Purpose To review the most recent literature on this topic to determine best evidence-based practice regarding withholding or not withholding feedings during RBC transfusions. Methods/search strategy Four databases were searched using keywords and MeSH terms including necrotizing enterocolitis, NEC, NPO, and transfusion, with specifications limiting the search to articles published in the last 10 years and limiting the population to neonates. Findings Four studies did not demonstrate a reduction in transfusion-associated enterocolitis (TANEC) with the implementation of feeding protocols during packed red blood cell (PRBC) transfusions. One study concluded that it could not confirm the benefit of withholding feeds during transfusion to reduce the risk of TANEC. A 2020 randomized controlled trial (RCT) found no difference in splanchnic oxygenation when enteral feeds are withheld, continued, or restricted during a PRBC transfusion. Holding feedings during PRBC transfusions did not result in adverse nutritional outcomes. Implications for practice To determine best evidence-based practice surrounding feeding protocols during RBC transfusions in very low-birth-weight and premature infants less than 37 weeks' gestation. Implications for research It is recommended that large, multicentered, adequately powered RCTs be conducted in this area. Individual institutions should standardize their practice to improve quality, safety, and patient outcomes.
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