Late erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants Updated

Aher SM, Ohls­son A Pub­lished Online: 23 April 2014

 

Back­ground: 

Low plas­ma lev­els of ery­thro­poi­etin (EPO) in preterm infants pro­vide a ratio­nale for the use of EPO to pre­vent or treat anaemia.

Authors’ con­clu­sions: 

Late admin­is­tra­tion of EPO reduces the use of one or more RBC trans­fu­sions, the num­ber of RBC trans­fu­sions per infant (< 1 trans­fu­sion per infant) but not the total vol­ume (ml/kg) of RBCs trans­fused per infant. Any donor expo­sure is like­ly not avoid­ed as most stud­ies includ­ed infants who had received RBC trans­fu­sions pri­or to tri­al entry. Late EPO does not sig­nif­i­cant­ly reduce or increase any clin­i­cal­ly impor­tant adverse out­comes except for a trend in increased risk for ROP. Fur­ther research of the use of late EPO treat­ment to pre­vent donor expo­sure is not indi­cat­ed. Research efforts should focus on lim­it­ing donor expo­sure dur­ing the first few days of life in sick neonates, when RBC require­ments are most like­ly to be required and can­not be pre­vent­ed by late EPO treat­ment. The use of satel­lite packs (divid­ing one unit of donor blood into many small­er aliquots) may reduce donor expo­sure.