Correlación entre transfusión de concentrados de glóbulos rojos y desarrollo de enterocolitis necrotizante en neonatos pretérminos menor a 2,500 gramos admitidos en el servicio de neonatología del Hospital Dr. Roberto Gilbert Elizalde durante enero a diciembre de 2019.

Abstract

Objective: To correlate the association between red blood cell transfusion and necrotizing enterocolitis in preterm newborns under 2,500 grams. • Background: Necrotizing enterocolitis is the most frequent and serious gastrointestinal disease in especially premature and low-birth-weight newborns, of multifactorial entity. Recent studies have reported an association between red blood cell transfusions and their development. Preterm newborns are a population susceptible to receiving multiple transfusions during their stay in neonatal therapies. Based on current clinical evidence, transfusion-associated enterocolitis appears to be a plausible clinical entity. • Materials and methods: Retrospective, observational, cross-sectional, analytical case-control study; Preterm newborns from a third level Pediatric Hospital in Guayaquil - Ecuador were included for a period of 1 year (2019). Transfusion-associated enterocolitis was defined as the onset of symptoms, in infants exposed to blood packs, within 0 to 72 hours post-transfusion. • Results: 278 newborns were analyzed, with an average weight of 1730,88 ± 424,71 g and a mean gestational age of 33,45 ± 2,12 weeks. 172 were diagnosed with necrotizing enterocolitis. More than half of the general population (152/278) received at least one red cell transfusion, of these, 33% developed transfusion-associated enterocolitis. The majority, 48%, corresponded to infants of very low birth weight (<1,500 g), and very premature (28 - 31 SG) 46%. No relationship was found between the transfusion frequency with more severe stages of the disease p = 0,868. Neonates with transfusion-associated enterocolitis were found to have a longer hospital stay of 15 days (p = 0,000; 95% CI 9,44 – 20,86) and almost 6 times more likely to die (OR: 5,9; CI 95% 2,4 – 14,56) than those with enterocolitis due to other factors. Finally, it was determined that there is no significant relationship between the transfusion of concentrated red blood cells and the development of necrotizing enterocolitis. (OR: 0,47; 95% CI 0,29 – 0,79). • Conclusions: Necrotizing enterocolitis is a multifactorial entity; erythrocyte transfusion is not equal to cause and effect for its development, but it is related to a third of the population that is exposed to blood cells. A preterm newborn with transfusion-associated enterocolitis will have longer hospital days and higher mortality rates.