Intestinal hypoperfusion and tissue injury in preterm infants V2
Research type
Research Study
Full title
Intestinal hypoperfusion and biomarkers of tissue injury and the effect of blood transfusion on these biomarkers in preterm infants
IRAS ID
208417
Contact name
Narendra Aladangady
Contact email
Sponsor organisation
Homerton University Hospital NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
The majority of preterm infants born before 30 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 with high morbidity and mortality among preterm infants. It occurs in about 10% of babies born before 30 weeks gestation and East London has the highest incidence of extremely preterm births as well as NEC in the UK. 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 already been identified as a priority.
We aim to investigate the effect of anaemia on gut blood flow and oxygen delivery, and changes in response to blood transfusion in 50 preterm infants born before 30 weeks of gestational age. Measurements will be made weekly of gut blood flow using established non-invasive methods and of markers of tissue injury in stool, urine and blood until 36 weeks postconceptional age. These measurements alongwith Doppler ultrasound scan of gut blood flow will also be performed before and after blood transfusion when a baby receives blood transfusion after 20 days of life for anaemia.
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
London - Central Research Ethics Committee
REC reference
16/LO/1353
Date of REC Opinion
27 Sep 2016
REC opinion
Further Information Favourable Opinion