{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T23:40:56Z","timestamp":1656546056646},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003In necrotizing enterocolitis (NEC), blood transfusions (BTs) are a disputed factor concerning the etiology and the outcome. We assessed retrospectively the effects of preonset BT on the outcome of NEC and spontaneous intestinal perforation (SIP).<\/jats:p><jats:p>\n          Materials and Methods\u2003With ethical consent, we reviewed the hospital records of 113 neonates from 2002 to 2019 with surgical NEC (NECs) (n\u2009=\u200957), conservatively treated NEC (NECc) (n\u2009=\u200920), and SIP (n\u2009=\u200936). The onset was defined as the day of surgery (NECs and SIP) or diagnosis (NECc). The effects of preonset BT (total, beyond 48\u2009hours, and within 48\u2009hours) were compared with the effects of birth weight (BW), gestational age (GA), intracerebral hemorrhage, respiratory distress syndrome, septicemia, and patent ductus arteriosus. Main outcome measure was 2-week mortality, and secondary measures were small intestinal loss and days on parenteral nutrition (PN).<\/jats:p><jats:p>\n          Results\u2003Overall mortality (8.9%) was predicted independently by BT total and BT beyond 48\u2009hours, risk ratio (RR)\u2009=\u20091.1 to 1.2 (95% confidence interval [CI]\u2009=\u20091.0\u20131.4), p\u2009=\u20090.01 to 0.02, and BW and GA, RR\u2009=\u20090.7 to 1.0 (95% CI\u2009=\u20090.5\u20131.0), p\u2009=\u20090.02 to 0.04. Mortality in NECs (12%) was predicted by BT total and BT beyond 48\u2009hours only, RR\u2009=\u20091.1 to 1.2 (95% CI\u2009=\u20091.0\u20131.5), p\u2009=\u20090.03 to 0.04. BT within 48\u2009hours of onset did not predict mortality. No factors were related with secondary outcome measures or with mortality in patients with SIP or NECc.<\/jats:p><jats:p>\n          Conclusion\u2003In NECs, preoperative BT and BT given more than 48\u2009hours before surgery were correlated with slightly increased 2-week mortality but not with small intestinal loss or duration of PN.<\/jats:p>","DOI":"10.1055\/s-0040-1721769","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T23:56:12Z","timestamp":1609372572000},"page":"251-257","source":"Crossref","is-referenced-by-count":0,"title":["The Outcome of Blood Transfusions in Conservative and Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation"],"prefix":"10.1055","volume":"32","author":[{"given":"Kristiina","family":"Karila","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children's Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antti","family":"Koivusalo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children's Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1038\/jp.2015.41","article-title":"Intestinal perforation in very preterm neonates: risk factors and outcomes","volume":"35","author":"J Shah","year":"2015","journal-title":"J Perinatol"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.jpedsurg.2009.02.013","article-title":"Mortality of necrotizing enterocolitis expressed by birth weight categories","volume":"44","author":"S C Fitzgibbons","year":"2009","journal-title":"J Pediatr Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/ANC.0000000000000063","article-title":"Prevention and early recognition of necrotizing enterocolitis: a tale of 2 tools--eNEC and GutCheckNEC","volume":"14","author":"S M Gephart","year":"2014","journal-title":"Adv Neonatal Care"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1111\/j.1537-2995.2009.02542.x","article-title":"Is \u201ctransfusion-associated necrotizing enterocolitis\u201d an authentic pathogenic entity?","volume":"50","author":"R D Christensen","year":"2010","journal-title":"Transfusion"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1038\/jp.2010.145","article-title":"Association of necrotizing enterocolitis with anemia and packed red blood cell transfusions in preterm infants","volume":"31","author":"R Singh","year":"2011","journal-title":"J Perinatol"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1053\/j.semperi.2016.09.021","article-title":"Should we believe in transfusion-associated enterocolitis? Applying a GRADE to the literature","volume":"41","author":"S Hay","year":"2017","journal-title":"Semin Perinatol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/adc.2004.051532","article-title":"In a preterm infant, does blood transfusion increase the risk of necrotizing enterocolitis?","volume":"90","author":"J C Agwu","year":"2005","journal-title":"Arch Dis Child"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1038\/s41372-019-0408-8","article-title":"Outcomes after implementing restrictive blood transfusion criteria in extremely premature infants","volume":"39","author":"D Knee","year":"2019","journal-title":"J Perinatol"},{"issue":"17","key":"ref9","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.3109\/14767058.2013.798283","article-title":"Factors affecting the severity of necrotizing enterocolitis","volume":"26","author":"C A Miner","year":"2013","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/pan.12485","article-title":"Blood transfusion in patients treated with surgery for necrotizing enterocolitis","volume":"25","author":"Z Ahmed","year":"2015","journal-title":"Paediatr Anaesth"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jss.2017.02.029","article-title":"Red blood cell transfusion in premature infants leads to worse necrotizing enterocolitis outcomes","volume":"213","author":"K E Cunningham","year":"2017","journal-title":"J Surg Res"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jpedsurg.2009.01.031","article-title":"Establishing norms for intestinal length in children","volume":"44","author":"M C Struijs","year":"2009","journal-title":"J Pediatr Surg"},{"issue":"10","key":"ref13","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1016\/j.jpedsurg.2018.07.020","article-title":"Outcomes of surgery for necrotizing enterocolitis and spontaneous intestinal perforation in Finland during 1986-2014","volume":"53","author":"K Karila","year":"2018","journal-title":"J Pediatr Surg"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1111\/trf.15112","article-title":"Platelet transfusions and mortality in necrotizing enterocolitis","volume":"59","author":"R M Patel","year":"2019","journal-title":"Transfusion"},{"issue":"03","key":"ref15","first-page":"296","article-title":"Surgical findings in transfusion-associated necrotizing enterocolitis","volume":"26","author":"M Couselo","year":"2016","journal-title":"Eur J Pediatr Surg"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"F10","DOI":"10.1136\/fetalneonatal-2011-301282","article-title":"Transfusion-associated necrotising enterocolitis in neonates","volume":"98","author":"A I Stritzke","year":"2013","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.clp.2018.09.006","article-title":"Epidemiology of necrotizing enterocolitis: new considerations regarding the influence of red blood cell transfusions and anemia","volume":"46","author":"V Saroha","year":"2019","journal-title":"Clin Perinatol"}],"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1721769.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T23:05:41Z","timestamp":1656543941000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1721769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,30]]},"references-count":17,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,6,29]]},"published-print":{"date-parts":[[2022,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1721769","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,30]]}}}