Early erythropoietin influences both transfusion and ventilation need in very low birth weight infants

The primary outcome measure of this study was the ability of rHuEPOα therapy to reduce transfusion needs, whereas secondary outcome measures were NICU-LOS and ventilation need.

All babies with BW <1250 g and GA <30 were eligible. Thirty premature neonates were enrolled in the study (10 treated, 20 controls). rHuEPOα was administered as 300 IU/kg/dose 3 times/week subcutaneously. Iron, folic acid and Vitamin E supplementation were administered in both groups. Hematologic variables and blood sampling were recorded during the study.

In rHuEPO group, only four (40%) premature infants required a transfusion, averaging 0.4 ± 0.52 transfusions/pts. A total of 23 transfusions were administered to controls; 11 (55%) infants received one transfusion at least, 55% required multiple transfusions. The average number of transfusions/pts was statistically different (1.15  ±  1.46 vs. 0.4 ± 0.52; p = 0.02), as the cumulative number of transfused patients (55% vs. 40%; p<0.001). NICU stay was not statistically different, whereas ventilation-free days were increased in EPO group (p<0.05).

R-Hu-EPO treatment in first post-natal weeks markedly enhanced erythropoiesis in severely premature infants compared with matched controls, with a significant impact on transfusion needs. EPO group experienced also a reduction of ventilation time and, possibly, a decreased occurrence of clinical BPD.