RBC Irradiation, Anemia and Gut Injury

Anemia and digestive tract complications are common problems in Extremely Low Birth Weight
infants. Anemia is a condition in which the body does not have enough red blood cells (RBC).
RBCs are important because they contain hemoglobin, the substance that carries oxygen
throughout the body. Transfusions of RBCs in these infants is frequently required to correct
the anemia. Oxygen levels in the digestive tract will be measured before, during and after
each blood transfusion using a tissue oxygen monitor called Near Infrared Spectroscopy
(NIRS). By using this technology, better understanding can be obtained of intestinal blood
flow patterns.

In addition, ELBW infants are more likely to have immature digestive systems and are at risk
for digestive tract problems such as necrotizing enterocolitis (NEC). NEC is a disease
characterized by infection and decreased blood flow to the intestines. NEC is a major cause
of devastating illness and death in this vulnerable preterm population. Leftover blood
samples, urine, stool, and breast milk samples will be collected, frozen, and stored. In the
event a baby develops a digestive tract complication they will be studied in a laboratory to
identify markers that indicate a healthy digestive tract versus illness.

Inclusion Criteria:

- Birth weight ≤1250 grams

- Postnatal age within 7 days of birth

Exclusion Criteria:

- Infant not expected to live beyond 7 days of life based on assessment of treating
neonatologist;

- Severe congenital abnormality expected to affect life expectancy;

- RBC or platelet transfusion at an outside institution occurring prior to screening;

- Maternal refusal to participate.