title: Erythropoietin therapy and preoperative autologous blood donation in children undergoing open heart surgery.
abstract: We assessed the feasibility and efficacy of subcutaneous erythropoietin alpha (EPO) therapy and preoperative autologous blood donation (ABD) in children undergoing open heart surgery. Thirty-nine children were treated consecutively with EPO (100 U x kg(-1) s.c. three times a week in the 3 weeks preceding the operation and i.v. on the day of surgery) and two ABDs were made (Group 1). As controls to compare transfusion requirements, 39 consecutive age-matched patients who had undergone open heart surgery during the two preceding years were selected (Group 2). In a mean time of 20 (SD 5) days, 96% of scheduled ABDs were performed and only three mild vasovagal reactions were observed. The mean volume of autologous red blood cells (RBC) collected was 6 (1) ml x kg(-1) and the mean volume of autologous RBC produced as a result of EPO therapy before surgery was 7 (3) ml x kg(-1), corresponding to a 28 (11)% increase in circulating RBC volume. The mean volume of autologous RBC collected was not different from that produced [6 (1) vs 7 (3) ml x kg(-1), P=0.4]. Allogenic blood was administered to three out of 39 children in Group 1 (7.7%) and to 24 out of 39 (61.5%) in Group 2. Treatment with subcutaneous EPO increases the amount of autologous blood that can be collected and minimizes allogenic blood exposure in children undergoing open heart surgery.
authors.affiliation: Department of Anesthesiology, Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Sonzogni
authors.forename: G
authors.initials: G
authors.lastname: Crupi
authors.forename: R
authors.initials: R
authors.lastname: Poma
authors.forename: F
authors.initials: F
authors.lastname: Annechino
authors.forename: F
authors.initials: F
authors.lastname: Ferri
authors.forename: P
authors.initials: P
authors.lastname: Filisetti
authors.forename: P
authors.initials: P
authors.lastname: Bellavita
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D004921:Erythropoietin / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D010976:Platelet Count; D011300:Preoperative Care / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods
chemical_list: D006454:Hemoglobins; D004921:Erythropoietin