Document Detail


The effectiveness of preoperative erythropoietin in averting allogenic blood transfusion among children undergoing scoliosis surgery.
MedLine Citation:
PMID:  9702670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Concerns about the transmission of the human immunodeficiency virus (HIV) have driven the evolution of surgical transfusion practices including the use of preoperative erythropoietin (rhEPO). Although there is significant experience documenting the efficacy of preoperative rhEPO in reducing transfusion requirements for adult patients, there is little experience in the pediatric population. With 178 pediatric patients who underwent surgery for spinal deformity, a retrospective cohort study was performed using patient charts, administrative records, and blood bank computer data. Of these patients, 44% received erythropoietin and 55% did not. From the entire population, 17.5% were in the rhEPO treatment group that received homologous blood transfusion compared with 30.6% in the untreated group (p < 0.05). Among the children with idiopathic scoliosis, this effect was more pronounced, with 3.9% of rhEPO patients receiving blood transfusion compared with 23.5% of nontreated patients (p = 0.006). Additionally, rhEPO treatment was associated with a significantly decreased length of stay only for patients in the idiopathic group (9.3 vs. 6.7, p = 0.02). Use of preoperative erythropoietin in pediatric patients undergoing scoliosis surgery resulted in higher preoperative hematocrit levels. Significantly lower rates of transfusion were noted only in the idiopathic group, however. Although there is a possibility of erythropoietin "resistance" in the neuromuscular and congenital patients, alternative explanations for the lack of effect on transfusion rates may include underdosing and biases existent in this nonrandomized retrospective study.
Authors:
M G Vitale; E J Stazzone; A C Gelijns; A J Moskowitz; D P Roye
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics. Part B     Volume:  7     ISSN:  1060-152X     ISO Abbreviation:  J Pediatr Orthop B     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-10-30     Completed Date:  1998-10-30     Revised Date:  2012-09-17    
Medline Journal Info:
Nlm Unique ID:  9300904     Medline TA:  J Pediatr Orthop B     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  203-9     Citation Subset:  IM; X    
Affiliation:
New York Orthopaedic Hospital, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Transfusion / statistics & numerical data*
Chi-Square Distribution
Child
Child, Preschool
Cohort Studies
Controlled Clinical Trials as Topic
Erythropoietin / administration & dosage*,  adverse effects
Female
Humans
Length of Stay / statistics & numerical data
Male
Orthopedics / methods*
Predictive Value of Tests
Preoperative Care
Recombinant Proteins
Retrospective Studies
Risk Assessment
Scoliosis / diagnosis,  surgery*
Software
Transplantation, Homologous
Treatment Outcome
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 11096-26-7/Erythropoietin

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


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