Document Detail


The effect of preoperative recombinant erythropoietin on postoperative hematocrit level after orthognathic surgery.
MedLine Citation:
PMID:  22939643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare the postoperative red cell mass as indicated by the hematocrit value of orthognathic surgery patients given iron supplementation and a single preoperative dose of erythropoietin alpha (EPO) and patients who did not receive either EPO or iron supplementation.
PATIENTS AND METHODS: Subjects who had a Le Fort I osteotomy (LFI) or a combination of LFI and bilateral sagittal split osteotomy between 2005 and 2008 and were aged at least 13 years were included. Subjects were excluded if they had a history of maxillofacial trauma, a craniofacial syndrome, or a major systemic medical condition. Subjects either had EPO administered with iron supplements before surgery (surgeon A protocol) or received neither (surgeon B protocol). Venous blood samples were taken, in accordance with clinic protocol, before surgery (before administration of EPO) and on postoperative day 1. Multiple linear regression with backward selection was used to analyze the change in hematocrit value. Explanatory variables included group, preoperative hematocrit level, age, gender, length of surgery, blood loss, and crystalloid (fluid replacement) volume.
RESULTS: The study included 178 eligible patients: 86 (48%) had a combination of LFI and bilateral sagittal split osteotomy and 92 (52%) had an isolated LFI. Of the patients, 114 (64%) had EPO/iron supplements administered before surgery whereas 64 did not. The mean change in hematocrit level as an indicator of the change in red cell mass was statistically significantly different (P = .01) for the subjects who received preoperative administration of EPO with iron supplementation compared with those who did not receive EPO plus iron. The administration of EPO plus iron was protective: the decrease in hematocrit level after surgery was smaller for subjects in the EPO group even after we controlled for age, gender, preoperative hematocrit level, length of surgery, blood loss, and crystalloid (fluid replacement) volume.
CONCLUSIONS: A single preoperative dose of erythropoietin with iron supplementation resulted in a smaller decrease, on average, in postoperative red cell mass as indicated by hematocrit value in patients with complicated orthognathic surgery procedures.
Authors:
Nicholas Politano; Michael Jaskolka; George Blakey; Timothy Turvey; Raymond White; Ceib Phillips
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-08-29
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  70     ISSN:  1531-5053     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-19     Completed Date:  2012-12-26     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e625-30     Citation Subset:  AIM; D; IM    
Copyright Information:
Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Blood Loss, Surgical
Chi-Square Distribution
Dietary Supplements
Erythropoietin / administration & dosage,  therapeutic use*
Female
Fluid Therapy
Hematocrit*
Humans
Injections, Subcutaneous
Iron / therapeutic use*
Linear Models
Male
Operative Time
Orthognathic Surgical Procedures*
Premedication*
Recombinant Proteins / administration & dosage,  therapeutic use
Retrospective Studies
Sex Factors
Young Adult
Grant Support
ID/Acronym/Agency:
R01 DE005215/DE/NIDCR NIH HHS; R01 DE005215/DE/NIDCR NIH HHS
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 11096-26-7/Erythropoietin; 7439-89-6/Iron
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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