Effect of single recombinant human erythropoietin injection on transfusion requirements in preoperatively anemic patients undergoing valvular heart surgery.
BACKGROUND
The authors investigated the effect of a single preoperative bolus of erythropoietin on perioperative transfusion requirement and erythropoiesis in patients with preoperative anemia undergoing valvular heart surgery.


METHODS
In this prospective, single-site, single-blinded, randomized, and parallel-arm controlled trial, 74 patients with preoperative anemia were randomly allocated to either the erythropoietin or the control group. The erythropoietin group received 500 IU/kg erythropoietin and 200 mg iron sucrose intravenously 1 day before the surgery. The control group received an equivalent volume of normal saline. The primary endpoint was transfusion requirement assessed during the surgery and for 4 days postoperatively. Reticulocyte count and iron profiles were measured serially and compared preoperatively and on postoperative days 1, 2, 4, and 7.


RESULTS
Transfusion occurred in 32 patients (86%) of the control group versus 22 patients (59%) of the erythropoietin group (P = 0.009). The mean number of units of packed erythrocytes transfused per patient during the surgery and for 4 postoperative days (mean ± SD) was also significantly decreased in the erythropoietin group compared with the control group (3.3 ± 2.2 vs.. 1.0 ± 1.1 units/patient, P = 0.001). The reticulocyte count was significantly greater in the erythropoietin group at postoperative days 4 (P = 0.001) and 7 (P = 0.001).


CONCLUSIONS
A single intravenous administration of erythropoietin and an iron supplement 1 day before surgery significantly reduced the perioperative transfusion requirement in anemic patients undergoing valvular heart surgery, implicating its potential role as a blood conservation strategy.
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University Health System, Seoul, Korea.
Young-Chul
YC
Yoo
Jae-Kwang
JK
Shim
Jong-Chan
JC
Kim
Youn-Yi
YY
Jo
Jong-Hoon
JH
Lee
Young-Lan
YL
Kwak
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy*; D001803:Blood Transfusion; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D007267:Injections; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D016037:Single-Blind Method
C554270:EPO protein, human; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron