Gut perfusion and gut injury in IUGR preterm infants
Research type
Research Study
Full title
The effect of anaemia and blood transfusion on gut tissue injury in intrauterine growth restricted (IUGR) preterm infants.
IRAS ID
250559
Contact name
Narendra Aladangady
Contact email
Sponsor organisation
Homerton University Hospital NHS Foundation Trust
Clinicaltrials.gov Identifier
, 18/ES/0107
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
The majority of preterm infants born before 31 weeks gestation receive multiple blood transfusions for anaemia (low haemoglobin [Hb] level). There is no universal cut off for transfusion meaning some babies may be exposed to severe chronic anaemia resulting in inadequate blood and oxygen supply to the gut. There is increasing concern that frequent blood transfusion may cause gut injury (inflammation and reperfusion injury) and predispose to Necrotising Enterocolitis (NEC).
NEC is a serious inflammatory disease of the gut affecting preterm infants, particularly intrauterine growth restricted (IUGR; poor fetal weight gain) infants. It occurs in about 10% of babies born before 31 weeks gestation and despite medical advances NEC still has a high morbidity and mortality. NEC is multifactorial and perfusion injury is a risk factor for its development.
There is a need to investigate the effects of anaemia on preterm gut tissue and whether low haemoglobin and/or transfusion are important risk factors for intestinal tissue injury. This area of research has been identified as a priority by international experts.
We aim to investigate the effect of anaemia on gut blood flow and oxygen delivery, and changes in response to blood transfusion in 43 IUGR preterm infants born before 31 weeks of gestational age. Measurements will be made weekly of gut blood flow and oxygen delivery using established non-invasive methods (Doppler Ultrasound Scan and Near Infrared Spectroscopy) and of markers of tissue injury in stool, urine and blood until 36 weeks postconceptional age. The measurement findings of the study will be compared with data already collected on 48 appropriately grown (AGA) preterm infants.
This project will provide information on the effect of chronic anaemia and blood transfusion on gut injury in preterm infants, and we hope will also provide guidance about the timing of blood transfusion.REC name
East of Scotland Research Ethics Service REC 2
REC reference
18/ES/0107
Date of REC Opinion
23 Oct 2018
REC opinion
Further Information Favourable Opinion