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British Journal of Anaesthesia, 2001, Vol. 87, No. 3 429-434
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Erythropoietin therapy and preoperative autologous blood donation in children undergoing open heart surgery

V. Sonzogni1, G. Crupi2, R. Poma3, F. Annechino2, F. Ferri1, P. Filisetti1 and P. Bellavita*,3

1Department of Anesthesiology, Ospedali Riuniti di Bergamo, Bergamo, Italy. 2Department of Cardiac Surgery Ospedali Riuniti di Bergamo, Bergamo, Italy. 3Blood Transfusion Service, Ospedali Riuniti di Bergamo, Bergamo, Italy*Corresponding author: Blood Transfusion Service, Ospedali Riuniti di Bergamo, Largo Barozzi n.1, I-24100 Bergamo, Italy

We assessed the feasibility and efficacy of subcutaneous erythropoietin alpha (EPO) therapy and preoperative autologous blood donation (ABD) in children undergoing open heart surgery. Thirty-nine children were treated consecutively with EPO (100 U kg–1 s.c. three times a week in the 3 weeks preceding the operation and i.v. on the day of surgery) and two ABDs were made (Group 1). As controls to compare transfusion requirements, 39 consecutive age-matched patients who had undergone open heart surgery during the two preceding years were selected (Group 2). In a mean time of 20 (SD 5) days, 96% of scheduled ABDs were performed and only three mild vasovagal reactions were observed. The mean volume of autologous red blood cells (RBC) collected was 6 (1) ml kg–1 and the mean volume of autologous RBC produced as a result of EPO therapy before surgery was 7 (3) ml kg–1, corresponding to a 28 (11)% increase in circulating RBC volume. The mean volume of autologous RBC collected was not different from that produced [6 (1) vs 7 (3) ml kg–1, P=0.4]. Allogenic blood was administered to three out of 39 children in Group 1 (7.7%) and to 24 out of 39 (61.5%) in Group 2. Treatment with subcutaneous EPO increases the amount of autologous blood that can be collected and minimizes allogenic blood exposure in children undergoing open heart surgery.

Br J Anaesth 2001; 87: 429–34


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