NPO during blood transfusions

[Courtney]

We are starting to make babies in our NICU NPO during blood transfusions to reduce the risk of NEC. Does anyone have any opinions on this matter, or follow the same practice?

[Agnieszka Domanska]

Could you explain what "NPO" means?

[Courtney]

Sure, I'm sorry. NPO means nothing to eat either by mouth or NG tube.

[Stefan Johansson]

We do not change feeding during transfusions.

[Agnieszka Domanska]

We also don't. And we do not observe higher incidence of NEC that could be connected with feeding during blood transfusion.

[manberbenitez]

we dont stop feeding during transfusions

[hehady]

As far as I know there is no evidence that keeping babies NPO during blood transfusion will reduce the incidence of NEC. Are you intersted in doing a RCT? do you have some lab animal data or observational studies?

[bittybabygrower]

We continue feeds.

[Agnieszka Domanska]

And btw , what is the theoretical background for not feeding the baby during blood transfusion? I mean, why should it cause NEC?

[JoannieO]

We continue to feed babies during a blood transfusion also. As far as I know there is no reason why the baby should develop NEC. However, if the baby is being transfused for increasing apneas and bradys and is unwell, we do check the crypt antigen status before transfusing, since a positive crypt antigen can indicate that the baby already has NEC.

Joan

[fishmanetc]

We have also started with keeping babies NPO 3 hours prior to and 6 hours post transfusion. I believe the theory which has been theorized but no actual clinical trials performed, is that of a reperfusion injury to the gut. We have had several cases in our NICU of otherwise stable kids developing bloody stools and a pneumatosis picture on
UB hours to even several days post transfusion, We have adopted an NPO approach in our practice.