Document Detail

Erythropoietic response to endogenous erythropoietin in premature very low birth weight infants.
MedLine Citation:
PMID:  19808699     Owner:  NLM     Status:  MEDLINE    
Despite the common occurrence of anemia in very low birth weight (VLBW) infants, the erythropoiesis and Hb production rates and their relationship to plasma erythropoietin (EPO) concentrations remain unknown in these subjects. To determine these quantities, all blood removed by phlebotomy and administered by red blood cell (RBC) transfusion over the first 30 days of life was recorded in 14 ventilated VLBW infants born at 24 to 28 weeks of gestation. Discarded blood from frequent clinically ordered laboratory blood samples was used to construct plasma EPO, Hb, and RBC concentration-time profiles for each infant. A pharmacodynamic Hb mass balance model that accounted for the dynamic hematological conditions experienced by these infants was simultaneously fitted to the plasma EPO, Hb, and RBC concentrations from each individual subject, while accounting for subject growth. Based on the model estimates, an average of 4.69 g of Hb was produced over the first 30 days of life, compared with 5.97 g removed by phlebotomies and 12.3 g administered by transfusions. These high transfusion amounts were consistent with a relatively short RBC life span and rapidly expanding blood volume with infant growth. The estimated mean body weight-scaled Hb production rate dropped nearly 3-fold after birth to 0.144 g/day x (kg)(3/4). Although only estimated in a subset of the subjects, the mean plasma EPO EC(50) of 28.5 mU/ml and maximal Hb production rate (E(max)) indicated that a severalfold increase in Hb production rate could be achieved with only a modest increase in plasma EPO concentrations.
Kevin J Freise; John A Widness; Peter Veng-Pedersen
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-10-06
Journal Detail:
Title:  The Journal of pharmacology and experimental therapeutics     Volume:  332     ISSN:  1521-0103     ISO Abbreviation:  J. Pharmacol. Exp. Ther.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-21     Completed Date:  2010-01-26     Revised Date:  2013-01-18    
Medline Journal Info:
Nlm Unique ID:  0376362     Medline TA:  J Pharmacol Exp Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  229-37     Citation Subset:  IM    
Division of Pharmaceutics, College of Pharmacy , The University of Iowa, Iowa City, IA 52242, USA.
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MeSH Terms
Birth Weight
Erythrocyte Transfusion
Erythropoiesis / physiology*
Erythropoietin / blood*
Gestational Age
Hemoglobins / analysis*
Infant, Newborn
Infant, Premature / blood*
Infant, Very Low Birth Weight / blood*
Models, Biological
Respiration, Artificial
Grant Support
2 P01-HL046925-11A1/HL/NHLBI NIH HHS; P01 HL046925/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Hemoglobins; 11096-26-7/Erythropoietin

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

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