Necrotizing enterocolitis after red blood cell transfusion in preterm infants with patent ductus arteriosus: a case series

Aim: Both patent ductus arteriosus (PDA) and packed red blood cell (PRBC) transfusion are risk factors for necrotizing enterocolitis (NEC). The combination of PDA and PRBC transfusion may have a synergistic effect on the intestinal circulation. Methods: We present four cases of NEC in very low birth weight (VLBW) infants within 14 h after PRBC transfusion. Results: All infants were growing on full enteral feeding, and they all had a PDA. Conclusion: We are concerned that the simultaneous presence of a PDA and PRBC transfusion in VLBW infants may place the infant at even greater risk of NEC than each of these factors alone.