Blood transfusion and necrotising enterocolitis in premature infants

Abstract

Overview of the topic: Necrotising Enterocolitis (NEC) is an acute, inflammatory disease of the bowel with an increased incidence in preterm infants due to the underdeveloped nature of their intestines. Transfusion-Associated Necrotising Enterocolitis (TANEC) is described as NEC which arises within 48 hours of a blood transfusion. This dissertation explores the incidence of NEC in premature infants after receiving a blood transfusion. The research question: Does blood transfusion in premature infants increase the risk of developing Necrotising Enterocolitis? PICO Elements: The Population (P) is premature infants, the Intervention (I) is blood transfusion, the Comparison (C) is not receiving blood transfusion, while the Outcome (O) is increased Necrotising Enterocolitis Method: Key words, and alternative words were generated to broaden the literature search. Boolean operators were additionally used to combine these key terms together. A comprehensive systematic search was conducted by means of HyDi, PubMed Central, Jama Network and Google Scholar, and a detailed inclusion and exclusion criteria was applied. The articles chosen were international studies written in the English language, available as full-text articles, published in the last ten years and peer-reviewed. Studies conducted on animals were excluded. The CASP tool appropriate for the study was used to critically appraise the selected literature. Outcome: The outcome measured was the incidence of NEC in premature infants. Results: The chosen literature included three cohort and four case-control studies. The evidence gathered was not highly conclusive, as only three studies conclude that RBC transfusion increases the risk of developing NEC, two studies conclude that RBC transfusion is an independent risk factor for the development of NEC and the remaining two studies are inconclusive. Conclusion: A definite conclusion could not be obtained; however, this dissertation provided a baseline for further research. Further research is required to answer the PICO question. Recommendations: To disseminate information through public talks, conferences, seminars, lectures, workshops, social media, and websites; all of which can be implemented locally. Further research with a larger population is necessary to increase awareness on TANEC and ultimately find a conclusive result.