Current controversies in the management of the anemia of prematurity.
Preterm infants, especially those with extremely low birth weight (ELBW) are exposed to frequent blood draws as part of their care in the neonatal intensive care unit. ELBW infants develop the anemia of prematurity (AOP), a hypo-proliferative anemia marked by inadequate production of erythropoietin (Epo). Treatment of AOP includes red blood cell transfusions, which are given to preterm infants based on indications and guidelines (hematocrit/hemoglobin levels, ventilation and oxygen need, apneas and bradycardias, poor weight gain) that are relatively non-specific. In this article we review recent studies evaluating transfusion guidelines, discuss ways to decrease phlebotomy losses and examine the use of red cell growth factors such as Epo in preventing and treating anemia in preterm infants.
Bishara
Nader
N
University of New Mexico School of Medicine, Albuquerque, NM 87131, USA. nbishara@salud.unm.edu
Ohls
Robin K
RK
D000751:Anemia, Neonatal / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D001803:Blood Transfusion / Q000379:methods*; D004921:Erythropoietin / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007235:Infant, Premature, Diseases / Q000097:blood / Q000188:drug therapy / Q000628:therapy*
D004921:Erythropoietin