Bierer Ryann, Roohi Mahshid, Peceny Connie, Ohls Robin K
Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USA.
J Pediatr Surg. 2009 Aug;44(8):1540-5. doi: 10.1016/j.jpedsurg.2008.10.112.
Limited erythropoietin (Epo) production diminishes neonates' ability to regenerate blood removed by phlebotomy. Neonates requiring surgery are at risk to receive multiple transfusions. We sought to determine if recombinant Epo administration to neonates requiring surgery would stimulate erythropoiesis.
Infants were randomized in double-masked fashion to receive Epo (200 units kg(-1) d(-1)) or placebo for 14 days. Complete blood count, absolute reticulocyte count (ARC), phlebotomy losses, and transfusions were measured during the study period. Infants were transfused using a strict transfusion protocol.
In the Epo group (n = 10, 2034 +/- 308 g, 8 +/- 2 days old; mean +/- SEM), ARC increased significantly, whereas in the placebo group (n = 10, 2400 +/- 184 g, 7 +/- 2 days old), ARC remained low. Hematocrits in the Epo group trended upward from 34.4 1.7% to 37.3 1.9% (although not statistically significant) despite phlebotomy losses of 53 +/- 12 mL/kg. Hematocrits in the placebo group were 35.9 1.8% and 33.2 1.6% on days 1 and 15, respectively, with phlebotomy losses of 27 +/- 5 mL/kg. There were no differences in absolute neutrophil counts or platelet counts between groups at the end of the study. No adverse effects were noted.
Infants randomized to Epo increased reticulocyte counts and hematocrits without adverse effects. Erythropoietin administration may provide an adjunct to present care in decreasing or eliminating erythrocyte transfusions in surgical neonates.
促红细胞生成素（Epo）生成受限会降低新生儿再生因静脉穿刺采血而流失血液的能力。需要手术的新生儿有接受多次输血的风险。我们试图确定对需要手术的新生儿给予重组促红细胞生成素是否会刺激红细胞生成。
婴儿以双盲方式随机分组，接受促红细胞生成素（200单位·千克⁻¹·天⁻¹）或安慰剂治疗14天。在研究期间测量全血细胞计数、绝对网织红细胞计数（ARC）、静脉穿刺采血量和输血量。婴儿按照严格的输血方案进行输血。
在促红细胞生成素组（n = 10，体重2034 ± 308克，8 ± 2日龄；均值 ± 标准误），ARC显著增加，而在安慰剂组（n = 10，体重2400 ± 184克，7 ± 2日龄），ARC保持在低水平。尽管静脉穿刺采血量为53 ± 12毫升/千克，但促红细胞生成素组的血细胞比容从34.4 ± 1.7%呈上升趋势至37.3 ± 1.9%（尽管无统计学意义）。安慰剂组在第1天和第15天的血细胞比容分别为35.9 ± 1.8%和33.2 ± 1.6%，静脉穿刺采血量为27 ± 5毫升/千克。研究结束时，两组之间的绝对中性粒细胞计数或血小板计数无差异。未观察到不良反应。
随机接受促红细胞生成素治疗的婴儿网织红细胞计数和血细胞比容增加，且无不良反应。给予促红细胞生成素可能为目前的治疗提供辅助，以减少或消除手术新生儿的红细胞输血。
