WithHolding or continuing Enteral feeds Around blood Transfusion (WHEAT) to prevent necrotising enterocolitis (NEC) in preterm infants

Abstract

Necrotising Enterocolitis (NEC) is a devastating neonatal disease associated with high risks of death and disability. The pathogenesis of NEC is incompletely understood but we know there is a temporal association between red cell transfusion and NEC. There is uncertainty about the impact of feeding during red cell transfusions and how this affects the chance of developing NEC. WHEAT aims to answer: In infants born <30 weeks (Patient), does withholding enteral feeds around the time of blood transfusion (Intervention), versus continued feeding around the time of blood transfusion (Comparator), reduce the rate of NEC after the first transfusion (Outcome)? Design/methods: Randomised, controlled, unblinded, multi-centre, comparative effectiveness superiority trial of two clinical care pathways. The two care pathways are: (1) Withholding feeds around transfusion; (2) Continuing feeds around transfusion. Expected outcomes: If withholding or continuing feeds during transfusion reduces the incidence of NEC, adopting this practice will help to improve preterm outcomes.