Necrotizing Enterocolitis Clinical Trial
Official title:
Impact of Red Cell Transfusion on Superior Mesenteric Artery Flow Patterns and Intestinal Oxygenation in Fed Preterm Neonates (SPARTAN: Sma PAttern Related to TrAnsfusion in Neonates)
This study aims to measure the changes induced by packed red blood cell (PRBC) transfusion in the superior mesenteric artery (SMA) flow velocity and intestinal oxygenation indices in premature neonates. These changes will be measured in relation to feeding, before and after a blood transfusion. Overall reduction of intestinal perfusion is a risk factor for necrotizing enterocolitis (NEC) - a condition with significant mortality and long term morbidity. Identifying specific patterns of flow velocity and tissue oxygenation changes will allow for planning, studying and implementing risk avoidance and minimization strategies.
Hypothesis: In preterm neonates the anticipated physiologic post-prandial increase in each
SMA flow and intestinal perfusion is blunted post transfusion. This is worse in SGA infants
and/or in the presence of a PDA.
Questions: 1) Does PRBC transfusion alter postprandial SMA flow increases and intestinal
oxygenation indices in preterm infants receiving enteral feeds? 2) Is there a difference in
postprandial SMA flow and intestinal perfusion changes in recently transfused SGA infants
compared to AGA infants, and in those with and without a PDA? Primary Outcome: Post-prandial
SMA flows changes before and after PRBC transfusion.
Secondary outcomes: Pre-post prandial changes in near-infrared spectroscopy (NIRS)-measured
intestinal oxygenation parameters before and after PRBC transfusion.
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