Serum erythropoietin concentrations fail to increase after significant phlebotomy losses in ill preterm infants.
OBJECTIVE/STUDY DESIGN: After blood loss, production of erythropoietin in adults increases, which accelerates erythropoiesis and restores the erythroid mass. It is unclear whether preterm infants with large phlebotomy losses have a similar response. We therefore measured serum erythropoietin concentrations in 11 ill preterm infants (1057 +/- 167 gm) as their phlebotomy losses accumulated.


RESULTS
Before the first transfusion, erythropoietin concentrations were 68.9 +/- 36.2 mU/ml (range 0 to 205 mU/ml) at 5 ml/kg blood out, 17.4 +/- 8.9 mU/ml at 10 ml/kg, and 4.8 +/- 2.6 mU/ml at 15 ml/kg. Erythropoietin concentrations did not increase in any patients despite increasing phlebotomy losses.


CONCLUSIONS
Serum erythropoietin concentrations in ill preterm infants do not increase in the face of significant blood loss. Although the mechanistic explanation for this failure is unclear, it likely contributes to the transfusion requirements of this population.
Ohls
R K
RK
Division of Neonatology, University of Florida College of Medicine, Gainesville, USA.
Harcum
J
J
Li
Y
Y
Davila
G
G
Christensen
R D
RD
D000751:Anemia, Neonatal / Q000097:blood* / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D004920:Erythropoiesis / Q000502:physiology; D004921:Erythropoietin / Q000097:blood* / Q000627:therapeutic use; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000628:therapy; D007262:Infusions, Intravenous; D018962:Phlebotomy / Q000009:adverse effects*; D011994:Recombinant Proteins; D012121:Respiration, Artificial; D016896:Treatment Outcome
D011994:Recombinant Proteins; D004921:Erythropoietin