Document Detail


The effect of erythropoietin on the transfusion requirements of preterm infants weighing 750 grams or less: a randomized, double-blind, placebo-controlled study.
MedLine Citation:
PMID:  9403642     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical trials of erythropoietin (EPO) administration to preterm infants have not focused on infants weighing 750 gm or less, the population most likely to receive multiple transfusions because of large phlebotomy losses. It is unknown whether preterm infants weighing 750 gm or less will respond to EPO by accelerating erythropoiesis, or whether EPO administered to this population will decrease blood transfusions. METHODS: We randomly assigned 28 extremely low birth weight preterm infants (mean +/- SEM: 24.7 +/- 0.3 weeks' gestation, 662 +/- 14 gm birth weight), in the first 72 hours of life, to receive either EPO (200 U/kg/day) or placebo for 14 days and administered transfusions only according to protocol over a 21-day study period. All infants received 1 mg/kg/day iron dextran in their total parenteral nutrition solution during the 14-day treatment period. RESULTS: During the 21-day study period, a lower number and volume of transfusions were received by the EPO recipients (4.7 +/- 0.7 transfusions per patient and 70 +/- 11 ml/kg per patient) than by the placebo recipients (7.5 +/- 1.1 transfusions per patient and 112 +/- 17 ml/kg per patient; p < 0.05, EPO vs placebo), whereas hematocrits remained similar in the two groups. Reticulocyte counts were similar in both groups on day 1 but were greater in the EPO recipients on day 14 (EPO day 1, 351 +/- 53; EPO day 14, 359 +/- 40 x 10(3)/microl; placebo day 1, 334 +/- 64; placebo day 14, 120 +/- 10 x 10(3)/microl; p < 0.01, EPO vs placebo). Serum ferritin concentrations were similar in both groups at the beginning of the study but were greater in the placebo recipients by day 14 (EPO, 262 +/- 44 microg/L; placebo, 593 +/- 92 microg/L; p < 0.01). No adverse effects of EPO or iron were noted. CONCLUSION: The combination of EPO and parenteral iron stimulates erythropoiesis in preterm infants weighing 750 gm or less and results in fewer transfusions during their first 3 weeks of life.
Authors:
R K Ohls; J Harcum; K R Schibler; R D Christensen
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  131     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-01-08     Completed Date:  1998-01-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  661-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, the University of New Mexico, Albuquerque 87131-5311, USA.
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MeSH Terms
Descriptor/Qualifier:
Anemia, Hemolytic / blood,  therapy*
Blood Transfusion*
Combined Modality Therapy
Double-Blind Method
Erythropoietin, Recombinant / therapeutic use*
Ferritins / blood
Gestational Age
Hematocrit / methods
Humans
Infant, Newborn
Infant, Premature, Diseases / blood,  therapy*
Infant, Very Low Birth Weight*
Iron / therapeutic use*
Parenteral Nutrition, Total
Reticulocyte Count
Grant Support
ID/Acronym/Agency:
HD-00988/HD/NICHD NIH HHS; HD-01006/HD/NICHD NIH HHS; HL-44951/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant; 7439-89-6/Iron; 9007-73-2/Ferritins
Comments/Corrections
Comment In:
J Pediatr. 1997 Nov;131(5):653-5   [PMID:  9403639 ]

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


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