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Erythropoietin Meta-analysis
The Effect of Recombinant Erythropoietin on Late Transfusions in the Neonatal Intensive Care Unit: A Meta-analysis. Garcia MG, Hutson AD, and Christensen RD. J Perinatol (March 2002) 22:108-11.
Eight randomized, placebo-controlled trials of recombinant erythropoietin (rEpo) administered to VLBW premature infants after the first week of life were included in this meta-analysis. Taken together, these studies involved 183 rEpo and 174 placebo recipients. The neonates in the rEpo group had fewer erythrocyte transfusions during the study period than those in the placebo group (odds ratio 0.33, 95% CI 0.21-0.51). The rEpo effect was a function of the dose of rEpo administered (p = 0.0001).
Comment. There is little question that rEpo is effective at stimulating erythrocyte production in premature neonates, and that this can result in requiring fewer late blood transfusions. Their remains some disagreement about whether the benefits gained are significant enough to justify the costs and the pain associated with rEpo administration. It should also be noted that multiple blood transfusions can be given from the same unit of blood, so there may be no difference between groups in the number of blood donors exposures. Another way to reduce the need for late blood transfusions in premature infants is early iron supplementation (see NeoNotes, Vol. 1, Issue 6, October 2000).
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