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Canadian Journal of Anesthesia

, Volume 52, Issue 2, pp 160–165 | Cite as

Two injections of erythropoietin correct moderate anemia in most patients awaiting orthopedic surgery

  • Nadia RosencherEmail author
  • Dominique Poisson
  • Aline Albi
  • Martine Aperce
  • Jeanne Barré
  • Charles Marc Samama
General anesthesia

Abstract

Background

The primary objective of this study was to assess the number of erythropoietin (EPO) injections required to reach a hematocrit (Ht) of 40% in moderately anemic patients. The secondary objective was to compare this strategy with autologous blood donation (ABD) in elective orthopedic surgery in terms of red blood cell (RBC) production.

Study design and methods

93 patients with a baseline Ht between 30 and 39% were randomized into two groups the day of the preoperative assessment. In the EPO group, patients received 40,000 UI/week sc until they reached a maximal Ht of 40%. In the ABD group, a RBC pack was collected every week as long as the Ht was above 33%.

Results

Two EPO injections were necessary to reach a 40% Ht in 63% of the patients. It was possible to collect two RBC packs in 45% of the patients in the ABD group. Volume of RBC production was significantly higher in the EPO group: 268 ± 142 mL vs 141 ± 129 (P = 0.0001). In the EPO group, Ht was significantly higher on days one and three after surgery and at discharge. The energy score was better in the EPO group. In the ABD group, 12.6% patients vs 6.5% in the EPO group received allogeneic transfusion (ns).

Conclusion

Only two EPO injections were sufficient to reach a Ht of 40% in the majority of patients. Therefore, to improve cost/effectiveness, the number of EPO injections should be related to baseline Ht instead of the four injections recommended in the product monograph.

Keywords

Bovine Spongiform Encephalopathy Anemic Patient Allogeneic Blood Allogeneic Transfusion Autologous Blood Donation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Deux injections d’érythropoïétine corrigent une anémie modérée chez la plupart des patients en attente d’une opération orthopédique

Résumé

Objectif

Évaluer le nombre d’injections d’érythropoïétine (EPO) nécessaires pour atteindre un hématocrite (Ht) de 40% chez des patients modérément anémiques. Aussi, comparer cette stratégie avec le don de sang autologue (DSA) en chirurgie orthopédique réglée en termes de production de globules rouges (GR).

Méthode

Des patients (n = 93) présentant un Ht de base de 30 à 39% ont été répartis en deux groupes le jour de l’évaluation préopératoire. Ceux du groupe EPO ont reçu 40,000 UI/semaine sc jusqu’à ce qu’ils présentent un Ht maximal de 40%. Dans le groupe DSA, un culot globulaire a été prélevé chaque semaine tant que l’Ht était au-dessus de 33%.

Résultats

Il a fallu deux injections d’EPO pour atteindre un Ht de 40% chez 63% des patients. Il a été possible de prélever deux culots chez 45% des patients du groupe DSA. Le volume de production de GR a été significativement plus élevé chez ceux du groupe EPO: 268 ± 142mL vs 141 ± 129 (P = 0,0001). Dans le groupe EPO, l’Ht a été significativement plus élevé aux jours un et trois après l’opération et au moment du congé. Le score d’asthénie était moins prononcé dans le groupe EPO. Une transfusion allogénique a été faite chez 12,6% des patients du groupe DSA vs 6,5% du groupe EPO (ns).

Conclusion

Il a suffi de deux injections d’EPO seulement pour atteindre un Ht de 40% chez la majorité des patients. Donc, pour améliorer l’efficacité des coûts, il faudrait relier le nombre d’injection d’EPO à l’Ht de base plutôt que de faire les quatre injections recommandées dans la monographie du produit.

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Copyright information

© Canadian Anesthesiologists 2005

Authors and Affiliations

  • Nadia Rosencher
    • 1
    Email author
  • Dominique Poisson
    • 2
  • Aline Albi
    • 1
  • Martine Aperce
    • 3
  • Jeanne Barré
    • 4
  • Charles Marc Samama
    • 5
  1. 1.From the Departments of AnesthesiaParis M5 University — Cochin HospitalParisFrance
  2. 2.Bichat University HospitalFrance
  3. 3.Poitiers University HospitalFrance
  4. 4.Reims University Hospital
  5. 5.Avicenne University HospitalBobignyFrance

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