RBC Transfusions-NEC?

http://www.jpeds.com/article/S0022-3476%2810%2900482-8/abstract

Results

The frequency of RBC transfusions was similar in NEC patients (47/93, 51%) and control patients (52/91, 58%). Late-onset NEC (>4 weeks of age) was more frequently associated with a history of transfusion(s) than early-onset NEC (adjusted OR, 6.7; 95% CI, 1.5 to 31.2; P = .02). Compared with nontransfused patients, RBC-transfused patients were born at earlier gestational ages, had greater intensive care needs (including at the time of onset of NEC), and longer hospital stay. A history of RBC transfusions within 48-hours before NEC onset was noted in 38% of patients, most of whom were extremely low birth weight infants.

Conclusions

In most patients, RBC transfusions were temporally unrelated to NEC and may be merely a marker of overall severity of illness. However, the relationship between RBC transfusions and NEC requires further evaluation in extremely low birth weight infants using a prospective cohort design.

My Word: Few recent studies did not show any correlation between transfusions and NEC. But,

my hypothesis is that: older the blood and lower the hct,

higher the chances for NEC or hematoschezia. Older blood may accumulate oxygen radicals secondary to hemolysis and cause vasoconstriction and ischemia.

Efficacy of Bifidobacterium breve and Lactobacillus casei oral supplementation on necrotizing enterocolitis in very-low-birth-weight preterm infants:a

http://www.ajcn.org/content/early/2010/10/27/ajcn.2010.29799.abstract
a double-blind, randomized, controlled trial
Design: A double-blind, randomized, controlled clinical trial was conducted in 231 preterm infants weighing from 750 to 1499 g at birth. The intervention group was composed of 119 infants who received human milk with probiotic supplementation (B. breve and L. casei) and a control group of 112 infants who received human milk containing no probiotics. The primary outcome was the occurrence of NEC stage ≥2 as defined by Bell's modified criteria.

Results: Four confirmed cases of NEC stage ≥2 by Bell's criterion occurred only in the control group.

Though the follow up is not mentioned in this article, they compared probiotic group with those receiving breast milk alone rather than with formula. That makes it interesting!