Pre-Op Erythropoietin Reduces Need for Peri-Op Transfusion

Also reduces the number of units of erythrocytes transfused during and after surgery

MONDAY, Oct. 31 (HealthDay News) -- Preoperative administration of erythropoietin and an iron supplement significantly reduces the requirement for perioperative transfusion in anemic patients undergoing valvular heart surgery, according to a study published in the November issue of Anesthesiology.

Young Chul Yoo, M.D., from Yonsei University Health System in Seoul, South Korea, and colleagues investigated the effect of a single preoperative bolus of erythropoietin on the perioperative transfusion requirement and erythropoiesis in 74 patients with preoperative anemia. Patients were randomly allocated to receive 500 IU/kg erythropoietin with 200 mg of iron sucrose intravenously, one day before the operation, or an equivalent volume of normal saline (control group). Assessment of the transfusion requirement during the operation and for four days postoperatively was the primary end point. Reticulocyte count and iron profiles were assessed and compared preoperatively and one, two, four, and seven days after the operation.

The investigators found that transfusion occurred in significantly more patients in the control group than the erythropoietin group (86 versus 59 percent). Compared with the control group, the erythropoietin group showed a significantly lower mean number of units of packed erythrocytes transfused per patient during the operation and for four days postoperatively. At postoperative days four and seven, the reticulocyte count was significantly greater in the erythropoietin group.

"Given the lack of complications of our treatment protocol and its compatibility with current inpatient optimization procedures, it should be considered as a promising blood conservation strategy in preoperatively anemic patients undergoing valvular heart surgery," the authors write.

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