Journal article
Pharmacodynamically optimized erythropoietin treatment combined with phlebotomy reduction predicted to eliminate blood transfusions in selected preterm infants
Pediatric research, Vol.75(2), pp.336-342
02/01/2014
DOI: 10.1038/pr.2013.213
PMCID: PMC4418561
PMID: 24216541
Abstract
BACKGROUND: Preterm very-low-birth-weight (VLBW) infants weighing < 1.5 kg at birth develop anemia, often requiring multiple red blood cell transfusions (RBCTx). Because laboratory blood loss is a primary cause of anemia leading to RBCTx in VLBW infants, our purpose was to simulate the extent to which RBCTx can be reduced or eliminated by reducing laboratory blood loss in combination with pharmacodynamically optimized erythropoietin (Epo) treatment.
METHODS: Twenty-six VLBW ventilated infants receiving RBCTx were studied during the first month of life. RBCTx simulations were based on previously published RBCTx criteria and data-driven Epo pharmacodynamic optimization of literature-derived RBC life span and blood volume data corrected for phlebotomy loss.
RESULTS: Simulated pharmacodynamic optimization of Epo administration and reduction in phlebotomy by >= 55% predicted a complete elimination of RBCTx in 1.0-1.5 kg infants. In infants <1.0 kg with 100% reduction in simulated phlebotomy and optimized Epo administration, a 45% reduction in RBCTx was predicted. The mean blood volume drawn from all infants was 63 ml/kg: 33% required for analysis and 67% discarded.
CONCLUSION: When reduced laboratory blood loss and optimized Epo treatment are combined, marked reductions in RBCTx in ventilated VLBW infants were predicted, particularly among those with birth weights >1.0 kg.
Details
- Title: Subtitle
- Pharmacodynamically optimized erythropoietin treatment combined with phlebotomy reduction predicted to eliminate blood transfusions in selected preterm infants
- Creators
- Matthew R. Rosebraugh - AbbVieJohn A. Widness - University of IowaDemet Nalbant - University of IowaGretchen Cress - University of IowaPeter Veng-Pedersen - Univ Iowa, Coll Pharm, Dept Pharmaceut, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- Pediatric research, Vol.75(2), pp.336-342
- Publisher
- Springer Nature
- DOI
- 10.1038/pr.2013.213
- PMID
- 24216541
- PMCID
- PMC4418561
- ISSN
- 0031-3998
- eISSN
- 1530-0447
- Number of pages
- 7
- Grant note
- P01 HL046925 / National Institutes of Health (NIH, Bethesda, MD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA P01HL046925 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) National Center for Research Resources; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) UL1RR024979 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) UL1RR024979 / National Center for Advancing Translational Sciences, NIH
- Language
- English
- Date published
- 02/01/2014
- Academic Unit
- Stead Family Department of Pediatrics; Pharmaceutical Sciences and Experimental Therapeutics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984622046102771
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