A Comparison of High versus Low Dose Recombinant Human Erythropoietin versus Blood Transfusion in the Management of Anaemia of Prematurity in a Developing Country
| Autor: | J.S. Galpin, Peter A. Cooper, Davies Va, Barbara J Cory, Daynia E Ballot, Minyon Avent, Gayle G. Sherman |
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| Rok vydání: | 2002 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Blood transfusion Anemia Injections Subcutaneous medicine.medical_treatment Population Hematocrit Anemia of prematurity South Africa Reference Values medicine Humans education Developing Countries Erythropoietin Probability education.field_of_study Chi-Square Distribution Dose-Response Relationship Drug medicine.diagnostic_test Anemia Neonatal business.industry Infant Newborn Gestational age medicine.disease Recombinant Proteins Treatment Outcome Infectious Diseases Pediatrics Perinatology and Child Health Female Apgar score Erythrocyte Transfusion business Packed red blood cells Infant Premature Follow-Up Studies |
| Zdroj: | Journal of Tropical Pediatrics. 48:227-233 |
| ISSN: | 1465-3664 0142-6338 |
| Popis: | The purpose of this study was to evaluate the effectiveness of early treatment with erythropoietin (EPO) in two different treatment regimes (high vs. low dose) in comparison to the conventional treatment of packed red blood cell (PRBC) transfusions in the management of anaemia of prematurity in a country with limited resources. An open controlled trial was conducted on 93 preterm infants (7 days postnatal age, 900-1500 g birthweight). Patients were randomly assigned either to a low dose (250 IU/kg), a high dose (400 IU/kg), or a control group. EPO was administered subcutaneously three times a week and all infants received 6 mg/kg iron orally from study entry to endpoint of therapy. Haematological parameters were measured and compared. The success was defined as an absence of transfusions and a haematocrit that did not fall below 30 per cent during the time period that the infants were in the study. The three groups were statistically comparable at study entry with respect to gestational age, birthweight, Apgar scores, and haematological values. Over the period that the infants were in the study, 75 per cent of the low dose group and 71 per cent of the high dose group met the criteria for success compared with 40 per cent in the control group (p < 0.001). However, there was no significant difference in the number of transfusions when the low and high EPO dose groups (9.5 per cent) were combined and compared with the control group (26.7 per cent) p = 0.0587. It was concluded that in stable infants, 900-1500 g, where phlebotomy losses are minimized and stringent transfusion guidelines are adhered to, EPO does not significantly decrease the number of transfusions. A conservative approach in the management of anaemia of prematurity, is a viable alternative in areas with limited resources. |
| Databáze: | OpenAIRE |
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