title: The efficacy of preoperative administration of a single dose of recombinant human erythropoietin in pediatric cardiac surgery.
abstract: BACKGROUND
  Preoperative autologous blood donation with recombinant human erythropoietin (rHuEPO) is effective in adults. However, there are problems concerning the blood access, cost, and blood storage in children. The purpose of this study was to evaluate the efficacy of administering a single dose of rHuEPO without blood donation in children undergoing pediatric cardiac surgery.
  
  
  METHODS
  Eighty-two children (72 with noncyanotic heart disease, and 10 with cyanotic heart disease) whose hematocrit values were less than 45% were included in this prospective, nonrandomized study. The children were divided into 3 groups: group E0 (n = 20) was not treated with rHuEPO and iron sulfate; group E2 (n = 27) was treated with 200 IU/kg of rHuEPO and 2 mg/kg of iron sulfate; and group E4 (n = 35) was treated with 400 IU/kg of rHuEPO and 4 mg/kg of iron sulfate. Administration of rHuEPO was performed subcutaneously 7 days before the operation. The hematological and iron parameters were measured perioperatively.
  
  
  RESULTS
  A lower proportion of children treated with rHuEPO (group E2, 14.8%; group E4, 22.9%) than children without rHuEPO (group E0, 40.0%) were exposed to RBC transfusions; however, there was no significance. The elevations of the hematocrit levels were 0.7% in group E0, 1.3% in group E2, and 1.9% in group E4. The elevation of the hematocrit was greater in patients with anemia (hematocrit < or =37%).
  
  
  CONCLUSIONS
  Although the effectiveness for avoiding transfusion was not clear, the administration of a single dose of rHuEPO without autologous blood donations had an effect by increasing hematocrit levels.
authors.affiliation: Department of Cardiothoracic Surgery, Kobe Children's Hospital, Kobe, Hyogo, Japan. y.ootaki@nifty.ne.j
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ootaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Shigeteru
authors.initials: S
authors.lastname: Oka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hasegawa
mesh_terms: D001774:Blood Chemical Analysis; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003490:Cyanosis / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000601:surgery*; D006400:Hematocrit; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D011994:Recombinant Proteins; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin