Late erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants

Aher, Sanjay M; Ohlsson, Arne

doi:10.1002/14651858.cd004868.pub3

Cited by 41 publications

(39 citation statements)

References 63 publications

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“…A Cochrane analysis of late rEPO usage concluded a significant effect of rEpo on reducing transfusions (typical RR; 0.66 (95% CI 0.59 to 0.74)) 64. However, as with the studies on early rEpo use, the question is raised of the value of one or two fewer late RBC transfusions.…”

Section: New Methods Aimed At Reducing the Need For Transfusionmentioning

confidence: 99%

Recent advances toward defining the benefits and risks of erythrocyte transfusions in neonates

Christensen

Ilstrup

2012

Arch Dis Child Fetal Neonatal Ed

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Section: New Methods Aimed At Reducing the Need For Transfusionmentioning

confidence: 99%

Recent advances toward defining the benefits and risks of erythrocyte transfusions in neonates

Christensen

Ilstrup

2012

Arch Dis Child Fetal Neonatal Ed

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“…Recent randomized controlled studies of small groups of very preterm (Fauchere et al, 2008) and extremely low birth weight infants (Juul et al, 2008) have shown that there were no significant adverse effects with early high‐dose recombinant EPO treatment, paving the way for larger trials. The initial concern about increased risk of thrombotic events reported for adults undergoing EPO therapy for chronic kidney failure has not been borne out for the neonate (Aher and Ohlsson, 2006). The first trial of EPO in full term neonates with moderate to severe hypoxia‐ischemia demonstrated that it reduced death and disability at 18 months from 44% (controls) to 25% (EPO‐treated) with no adverse effects (Zhu et al, 2009).…”

Section: Potential Therapeutic Agents and When To Administer Themmentioning

confidence: 99%

The biological basis of injury and neuroprotection in the fetal and neonatal brain

Rees

Harding

Walker

2011

Intl J of Devlp Neuroscience

180

162

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A compromised intrauterine environment that delivers low levels of oxygen and/or nutrients, or is infected or inflammatory, can result in fetal brain injury, abnormal brain development and in cases of chronic compromise, intrauterine growth restriction. Preterm birth can also be associated with injury to the developing brain and affect the normal trajectory of brain growth. This review will focus on the effects that episodes of perinatal hypoxia (acute, chronic, associated with inflammation or as an antecedent of preterm birth) can have on the developing brain. In animal models of these conditions we have found that relatively brief (acute) periods of fetal hypoxemia can have significant effects on the fetal brain, for example death of susceptible neuronal populations (cerebellum, hippocampus, cortex) and cerebral white matter damage. Chronic placental insufficiency which includes fetal hypoxemia, nutrient restriction and altered endocrine status can result in fetal growth restriction and long-term deficits in neural connectivity in addition to altered postnatal function, for example in the auditory and visual systems. Maternal/fetal inflammation can result in fetal brain damage, particularly but not exclusively in the white matter; injury is more pronounced when associated with fetal hypoxemia. In the baboon, in which the normal trajectory of growth is affected by preterm birth, there is a direct correlation between a higher flux in oxygen saturation and a greater extent of neuropathological damage. Currently, the only established therapy for neonatal encephalopathy in full term neonates is moderate hypothermia although this only offers some protection to moderately but not severely affected brains. There is no accepted therapy for injured preterm brains. Consequently the search for more efficacious treatments continues; we discuss neuroprotective agents (erythropoietin, N-acetyl cysteine, melatonin, creatine, neurosteroids) which we have trialed in appropriate animal models. The possibility of combining hypothermia with such agents or growth factors is now being considered. A deeper understanding of causal pathways in brain injury is essential for the development of efficacious strategies for neuroprotection.

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“…The first clinical trials in preterm neonates showed that the early use of Epo (started in the first week of life) was associated with decreased RBC transfusion requirements [24]. 7 ml), and of questionable clinical significance [26]. 'Late' Epo treatment (after day of life 7) also decreased the need for transfusions in preterm neonates, but the reduction in transfusion volume achieved by using Epo was small (approx.…”

Section: Erythropoietic Growth Factorsmentioning

confidence: 99%

Clinical and research issues in neonatal anemia and thrombocytopenia

Sallmon

Sola‐Visner

2012

Current Opinion in Pediatrics

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Late erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants

Cited by 41 publications

References 63 publications

Recent advances toward defining the benefits and risks of erythrocyte transfusions in neonates

Recent advances toward defining the benefits and risks of erythrocyte transfusions in neonates

The biological basis of injury and neuroprotection in the fetal and neonatal brain

Clinical and research issues in neonatal anemia and thrombocytopenia

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