Efficacy and cost analysis of treating very low birth weight infants with erythropoietin during their first two weeks of life: A randomized, placebo-controlled trial☆,☆☆,★,★★
Section snippets
METHODS
Infants were eligible for study if they required intensive care, were less than 48 hours of age, weighed between 750 and 1500 gm at birth, were born at ≥27 weeks of gestation, and had hematocrits between 0.40 and 0.60. Infants were ineligible for study if hemolytic or hemorrhagic disease was documented, or if, during mechanical ventilation, more than 80% oxygen was required for the preceding 4 hours. Infants were also ineligible if congenital heart disease or disease requiring immediate
RESULTS
After the interim analysis, the study was discontinued because of significant differences between groups in number of transfusions. Twenty patients were enrolled. There were no differences between groups in birth weight, gestational age, or age at the time of study entry (Table I). There were also no differences between groups in hematocrit, absolute reticulocyte count, or blood lactate concentration.
Changes in absolute reticulocyte count are shown in the upper panel of the Figure. Reticulocyte
DISCUSSION
After blood loss, adult subjects promptly increase production of endogenous erythropoietin, and the subsequent acceleration in erythropoiesis restores the erythroid mass.11 A limited capacity to increase serum concentrations of erythropoietin during anemia appears to render VLBW infants less capable of compensating for blood loss.12, 13 The number of transfusions given to VLBW infants in the first few weeks of life remains a significant problem.1 One recently studied alternative to transfusions
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2011, Fetal and Neonatal Physiology E-Book, Fourth EditionErythropoietin treatment for late anaemia after haemolytic disease of the newborn
2010, Anales de PediatriaAnemia in the Preterm Infant: Erythropoietin Versus Erythrocyte Transfusion-It's not that Simple
2009, Clinics in PerinatologyCitation Excerpt :The results varied, and the relative benefit of r-EPO for AOP is related to the study design (early versus late treatment; liberal versus restrictive transfusion criteria), patient population, and value assigned to complex outcomes. Not all studies took into account the risk of infection transmission, exclusion of which would lower the cost of transfusion.32 Studies evaluating the cost of treating stable, growing premature infants with r-EPO are more likely to favor RBC transfusion over r-EPO than are studies focused on sicker premature infants at greater risk for RBC transfusion.72,74
Is there a role for erythropoietin in neonatal medicine?
2008, Early Human Development
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From the Division of Neonatology, University of Florida, Gainesville, and the Division of Human Development and Aging, University of Utah School of Medicine, Salt Lake City
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Supported by grants HD-00988 and HL-44951 from the National Institutes of Health, grant RR-00064 from the National Center for Research Resources, and an award from the Children's Miracle Network Telethon.
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Reprint requests: Robin K. Ohls, MD, Division of Neonatology, University of Florida College of Medicine, P.O. Box 100296, JHMHC, Gainesville, FL 32610-0296.
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