Document Detail

Recombinant erythropoietin and blood transfusion in selected preterm infants.
MedLine Citation:
PMID:  12496225     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To comprehensively identify preterm infants likely to require blood transfusion and to investigate the effectiveness of recombinant erythropoietin in this high risk subgroup. DESIGN: Double blind randomised controlled trial. SETTING: Neonatal Intensive Care Unit, Middlemore Hospital, Auckland, New Zealand. PATIENTS: Preterm infants < 33 weeks gestation and < 1700 g birth weight meeting specific criteria indicating a high possibility of requiring blood transfusion. INTERVENTIONS: Predictors of blood transfusion were determined by analysis of preterm infants admitted to a neonatal intensive care unit over a two year period. Using the criteria developed, high risk infants entered the study and received erythropoietin or sham treatment until 34 weeks completed gestation. The sample size was calculated to detect a reduction of one blood transfusion per infant (significance level 5%, power 80%). RESULTS: The selection criteria had a positive predictive value for transfusion of 91% and a negative predictive value of 94%. Mean birth weights and gestational ages were similar in the two groups. Absolute reticulocyte counts and haemoglobin values were higher in the group receiving erythropoietin. There was no significant difference in the number of blood transfusions received in the treatment and control groups. However, comparing transfusions given to < 1000 g infants after 30 days of age, there were significantly fewer transfusions in the erythropoietin group (mean (SD) 0.5 (0.7) in those receiving erythropoietin and 1.6 (1.1) in the controls). No adverse effects were noted. CONCLUSIONS: The selection criteria for the study were highly predictive of subsequent transfusion. In the group receiving erythropoietin, a reduction in transfusion requirements was apparent only in the < 1000 g birthweight group after 1 month of age.
M P Meyer; E Sharma; M Carsons
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  88     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2002-12-23     Completed Date:  2003-01-23     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F41-5     Citation Subset:  AIM; IM    
Neonatal Unit, Kidz First, Middlemore Hospital and the University of Auckland, New Zealand.
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MeSH Terms
Blood Cell Count
Blood Donors
Blood Transfusion*
Double-Blind Method
Erythropoietin, Recombinant / therapeutic use*
Infant, Newborn
Infant, Premature*
Infant, Premature, Diseases / therapy*
Reg. No./Substance:
0/Erythropoietin, Recombinant

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