Necrotizing enterocolitis and its relationship to red blood cell concentrates - a clinical case review

Abstract

Necrotizing enterocolitis (NEC) is a multifactorial disease that occurs in 10% of all preterm, low-weight for gestational age infants. Considered one of major causes of morbidity and mortality in neonates and up to now we have failed to impact the incidence of NEC in newborn units. In preterm, low-weight infants, there is a temporary association between the transfusion of packed red blood cells and the development of NEC in the first 48 hours after initiating the transfusion. It has been found that NEC following a transfusion or transfusion-associated NECs are more severe than non transfusion-related NECs and require surgical intervention that increases the risk of future complications and death. The triggering mechanism is yet unknown; however, there are some theories about some predisposing factors such as anemia, feedingrelated blood flow disruptions, and transfusion-associated ischemic/reperfusion events. A clinical case of post-transfusion NEC is discussed.