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Published on: June 24, 2020
Red blood cell transfusions increase fecal calprotectin levels in premature infants
T T B Ho1, M W Groer2, A A Luciano1
1Department of Pediatrics, University of South Florida, Tampa, FL, USA.
Insights
Red blood cell (RBC) transfusions increase intestinal inflammation in very low birth weight (VLBW) infants. Factors like lower hematocrit and prolonged RBC storage time are linked to this inflammation.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Hematology
Background:
- Very low birth weight (VLBW) infants are susceptible to intestinal complications.
- Red blood cell (RBC) transfusions are common in VLBW infants.
- The impact of RBC transfusions on intestinal inflammation in VLBW infants requires further investigation.
Purpose of the Study:
- To investigate the influence of RBC transfusions on intestinal inflammation in VLBW infants.
- To determine if hematocrit (Hct) levels during transfusion and RBC storage duration correlate with intestinal inflammation.
Main Methods:
- Prospective enrollment of VLBW infants without major congenital defects or pre-existing intestinal issues.
- Measurement of fecal calprotectin (FC) levels before and after RBC transfusions.
- Collection of data on infant Hct and RBC storage time.
Main Results:
- Fecal calprotectin (FC) levels increased significantly post-RBC transfusion (P=0.018).
- Higher FC levels were observed in infants receiving multiple transfusions and with prolonged RBC storage (>21 days).
- Lower Hct levels at transfusion correlated with increased FC levels (P=0.044).
Conclusions:
- RBC transfusions are associated with increased intestinal inflammation in VLBW infants.
- Anemia and prolonged storage of RBCs are linked to heightened intestinal inflammation.
- Findings suggest careful consideration of transfusion parameters in VLBW infants.
Objective:
We hypothesized that red blood cell (RBC) transfusions influence intestinal inflammation in very low birth weight (VLBW) infants. We also suspected that hematocrit (Hct) at transfusions and RBC storage time correlate with intestinal inflammation.
Study Design:
VLBW infants, without major congenital defects, intestinal perforation or necrotizing enterocolitis, were enrolled prospectively. Fecal calprotectin (FC) levels were measured from stool samples collected before and after RBC transfusions. Data on Hct and RBC storage time were collected.
Result:
Data from 42 RBC transfusions given to 26 infants revealed that FC levels increased faster than baseline after RBC transfusions (P=0.018) and were higher in multiple-transfused infants (0 to 48 and >48 h post transfusion, P=0.007 and P=0.005, respectively). Lower Hct and RBC storage >21 days correlated with higher FC levels (P=0.044 and P=0.013, respectively).
Conclusion:
RBC transfusions, anemia and prolonged RBC storage were associated with an increase in intestinal inflammation.
