Blood transfusions are common in the NICU. Although blood transfusions can be lifesaving, they are not without risks such as necrotizing enterocolitis (NEC). NEC is an inflammation in the bowel that can lead to perforation, bowel loss, and death. Research indicates that there is a correlation between NEC and blood transfusions. There is no agreed-upon cause of NEC, but most of the research supports the need for holding feedings while being transfused. This article provides an evidence-based protocol, based on retrospective chart reviews of 24 neonates, for how long to hold the feedings before, during, and after the transfusion. This protocol was implemented in an NICU where the NEC cases related to blood transfusions were as high as 25 percent and decreased to as low as 4 percent after the protocol was implemented.
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