Document Detail


Effectiveness of perioperative recombinant human erythropoietin in elective hip replacement. Canadian Orthopedic Perioperative Erythropoietin Study Group.
MedLine Citation:
PMID:  8098389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Concern about the risk of transmission of viral infection has led to attempts to reduce transfusion requirements in patients undergoing surgery. To determine whether recombinant human erythropoietin decreases blood transfusion requirements in patients undergoing elective hip arthroplasty, a multicentre double-blind, randomised, placebo-controlled trial was conducted. 208 patients undergoing elective primary or revision hip arthroplasty were randomised to 3 groups. All received daily subcutaneous injections of either erythropoietin or placebo starting 10 days before surgery. Group 1 (78 patients) received 14 days of placebo, group 2 (77 patients) received 14 days of erythropoietin (300 units/kg to a maximum of 30,000 units), and group 3 (53 patients) received placebo for days 10 to 6 before surgery and erythropoietin for the next 9 days. A primary outcome event (any transfusion or a haemoglobin concentration < 80 g/L) occurred in 46% of patients in group 1, 23% in group 2, and 32% in group 3 (p = 0.003). The mean number of transfusions was 1.14 in group 1, 0.52 in group 2, 0.70 in group 3. The mean reticulocyte count the day before surgery was 72 x 10(9)/L in group 1, 327 in group 2, and 170 in group 3. Deep venous thrombi were detected in 5 patients in group 1, 8 patients in group 2, and 8 patients in group 3. Patients who had a haemoglobin concentration before randomisation of < 135 g/L benefited most from erythropoietin. Thus erythropoietin given for 14 days perioperatively decreases the need for transfusion in patients undergoing elective hip arthroplasty.
Authors:
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  341     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-06-14     Completed Date:  1993-06-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1227-32     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Cell Count
Blood Loss, Surgical
Blood Pressure
Blood Transfusion / utilization*
Double-Blind Method
Drug Administration Schedule
Erythropoietin / administration & dosage*
Female
Ferritins / blood
Follow-Up Studies
Hemoglobins / analysis
Hip Prosthesis*
Humans
Injections, Subcutaneous
Iron / administration & dosage,  therapeutic use
Male
Middle Aged
Postoperative Complications
Recombinant Proteins / administration & dosage
Thrombophlebitis / etiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hemoglobins; 0/Recombinant Proteins; 11096-26-7/Erythropoietin; 7439-89-6/Iron; 9007-73-2/Ferritins
Comments/Corrections
Comment In:
Lancet. 1993 Jun 26;341(8861):1665   [PMID:  8100030 ]
Lancet. 1993 Jun 26;341(8861):1665   [PMID:  8100031 ]

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


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