FEEding DURing red cell transfusion (FEEDUR RCT): a multi-arm randomised controlled trial

Area of Science:

• Neonatal Medicine
• Pediatric Gastroenterology
• Critical Care

Background:

• Necrotising Enterocolitis (NEC) is a severe neonatal condition.
• Concerns exist regarding the impact of enteral feeding during red blood cell transfusions on NEC.
• Splanchnic oxygenation is a key factor in neonatal gut health.

Purpose of the Study:

• To evaluate the effect of different enteral feeding strategies on splanchnic oxygenation in preterm infants undergoing red blood cell transfusion.
• To assess the safety and feasibility of various feeding regimens during transfusion.

Main Methods:

• A randomized controlled trial involving preterm infants (<35 weeks gestational age) receiving red cell transfusions.
• Three groups were compared: withholding feeds, continuing feeds, or restricting feed volume during transfusion.
• Splanchnic oxygenation was measured using the splanchnic-cerebral oxygenation ratio (SCOR) and fractional oxygen extraction (FOE).

Main Results:

• No significant differences in SCOR or FOE were observed between the three feeding groups during or after transfusion.
• All infants tolerated the transfusion and feeding regimens without developing NEC.
• A slight increase in SCOR and decrease in FOE were noted from the start to the end of transfusion across all groups.

Conclusions:

• Withholding, continuing, or restricting enteral feeds during red cell transfusion did not impact splanchnic oxygenation in preterm infants.
• The study demonstrated the feasibility of conducting research on feeding strategies during transfusions in this vulnerable population.
• Further large-scale trials are warranted to confirm these findings and assess clinical outcomes.