title: Changes in hematocrit following a blood transfusion does not influence the risk for necrotizing enterocolitis: A case-control study.
abstract: OBJECTIVE
  Transfusion Associated Necrotizing Enterocolitis (TANEC) is defined as the onset of necrotizing enterocolitis (NEC) within 48 hours of receiving a blood transfusion in preterm neonates. We wanted to determine if hematocrit changes following blood transfusions were associated with disease development.
  
  
  METHODS
  This is a case-control analysis of inborn neonates ≤32 weeks' gestational age, from January 1, 2007 and December 31, 2010, who were diagnosed with Bell stage II or greater NEC. Those meeting TANEC criteria were identified and an analysis completed to determine if beginning or ending hematocrit values were associated with an increased risk for disease development.
  
  
  RESULTS
  Nineteen of forty-nine (39%) infants with NEC met the criteria for TANEC. We found no differences in gestational age at birth or birth weight in our experimental groups. The degree of illness including PDA, IVH, central line use, and respiratory support 48 hours prior to disease onset was also similar between groups. Those with TANEC had higher modified Bell staging of NEC and were more likely to be receiving full enteric feeds at the time of NEC onset. No statistically significant differences were found in hematocrit levels prior to or following the blood transfusion closest to NEC onset in the TANEC group, as compared to classic NEC (CNEC) or control infants.
  
  
  CONCLUSIONS
  The onset of NEC following transfusion occurs with a frequency that invites investigation regarding causation. Our data indicates no association between the beginning and ending hematocrit values and TANEC in our patient population.
authors.affiliation: Department of Pediatrics, Section of Neonatal-Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Lawrence
authors.affiliation: Department of Pediatrics, Section of Neonatal-Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: R
authors.initials: R
authors.lastname: Nandyal
authors.affiliation: Department of Pediatrics, Section of Neonatal-Perinatal Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: G
authors.initials: G
authors.lastname: Hallford
authors.affiliation: Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: M
authors.initials: M
authors.lastname: Anderson
authors.affiliation: Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: N
authors.initials: N
authors.lastname: Hart
mesh_terms: D016022:Case-Control Studies; D004750:Enteral Nutrition; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006400:Hematocrit / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D065227:Transfusion Reaction; D016896:Treatment Outcome
keywords: NEC; blood transfusion; classic NEC (CNEC); hematocrit; neonates; transfusion associated necrotizing enterocolitis (TANEC)