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ARTICLE:
Robin K. Ohls, Richard A. Ehrenkranz, Linda L. Wright, James A. Lemons, Sheldon B. Korones, Barbara J. Stoll, Ann R. Stark, Seetha Shankaran, Edward F. Donovan, Nicole C. Close, Abhik Das, and for the National Institute of Child Health and Human Development Neonatal Research Network
Effects of Early Erythropoietin Therapy on the Transfusion Requirements of Preterm Infants Below 1250 Grams Birth Weight: A Multicenter, Randomized, Controlled Trial
Pediatrics 2001; 108: 934-942 [Abstract] [Full text] [PDF]
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[Read eLetters] Role of Erythropoietin Treatment on the Blood Transfusion in Preterm Infants
Sunil Jain   (21 April 2002)

Role of Erythropoietin Treatment on the Blood Transfusion in Preterm Infants 21 April 2002
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Sunil Jain,
Physician
Division of Neonatology in Department of Pediatrics at St John,s Hospital, Springfield IL

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Re: Role of Erythropoietin Treatment on the Blood Transfusion in Preterm Infants

jainsunil{at}hotmail.com Sunil Jain

We discussed this randomized, multicenter controlled study with great interest. You selected the exactly right population of infants who need repeated blood transfusion (BT) during their stay in the nonatal intensive care unit (NICU). In the results, the standrad deviation (SD) was wide because the BT requirements in an infant who is born with birth weight (BW) of 400 g may be upto 10 as compared to the one who is born with BW of 1000 g. The infants born with BT of <750 g need maximum number of BT during their NICU stay. Comparing this group of infants would be a better choice and may reduce the SD as well. Sick infants may not respond to erythropoietin (Epo) as effeciently as healthy infants. To eliminate this confounding factor, Score for Neonatal Acute Physiology SNAP) should be considred(1). The phlebotomy losses should be percentage of the weight of the infant rather than amount of blood because loss of 5 mL of blood may not be significant in 1250 g infant as compared to a 400 g infant. In the methods, the plan was to followm up these infants up to 35 weeks corrected gestation but the results show only 10 weeks follow up. If an infant was born with BW of 400 g and the infant was approperiate for age, then the gestation will be <24 weeks. In that case, the follow up should be >10 weeks. 1. D.K. Richardson et al. SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores. J Pediatr 2001; 138: 92-100