Abstract
The aim of our study was to evaluate bone marrow stimulation and bone marrow response to post-operative anaemia in children after open heart surgery. In 16 children (age 5.7±0.9 years, weight 20.1±3.2 kg) serum erythropoietin, haematocrit, reticulocyte count, ferritin, transferrin saturation and C-reactive protein were assessed perioperatively after cardiopumonary bypass for surgical repair of atrial septal defect. Erythropoietin increased seven fold from 14±6.2 (7–30) to 80±49 (20–171) mU/ml (P<0.05) and the reticulocyte count a 1.7-fold from 11.1±3.1 (6–19) to 18.4±5.9 (10–31) ‰ (P<0.05). Transferrin saturation was inversely correlated to C-reactive protein.
Conclusion
These findings suggest adequate bone marrow stimulation but an inadequate bone marrow response during the immediate perioperative period, caused by inhibition of erythropoesis by acute postoperative inflammation in children after open heart surgery.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- ASD :
-
atrial septal defect
- CRP :
-
C-reactive protein
- POD :
-
postoperative day
- PRE :
-
pre-operative
References
Birgegard G (1989) Erythropoiesis and inflammation. Contrib Nephrol 76: 330–341
Bourke DL, Smith TC (1974) Estimating allowable hemodilution. Anesthesiology 41: 609–613
Bove JR (1987) Transfusion associated hepatitis and AIDS. N Engl J Med 317: 242–245
D'Arabra MN, Risk C, Schneider RC, Vlahakes G, Lynch K (1990) Effect of elective cardiopulmonary bypass (CPB) surgery and hemodilution on serum erythropoietin levels and erythropoesis. Anesthesiology 73: A106
Erslev AJ, Wilson J, Caro J (1987) Erythropoietin titers in anemic, non uremic patients. J Lab Clin Med 109: 429–434
Finch CA (1982) Erythropoiesis, erythropoietin and iron. Blood 60: 1241–1248
Honig CL, Bove JR (1984) Transfusion associated fatalities. Review of Bureau of Biologics reports 1976–1978. Transfusion 20: 653–658
Levine EA, Rosen AL, Sehgal LR, Gould SA, Egrie JC, Moss GS (1991) erythropoietin deficiency after coronary artery bypass procedures. Ann Thorac Surg 51: 764–766
Miholic J, Hiertz H, Hudec M, Laczkovics A, Domanig E (1984) Fever, leucocytosis and infection after open heart surgery. A log-linear regression analysis of 115 cases. Thorac Cardiovasc Surg 32: 45–48
Rosen AL, Gould SA, Sehgal LR, Levine EA, Sehgal HL, Goldwasser E, Beaver CW, Moss GS (1990) Erythropoetic response to acute anemia. Crit Care Med 18: 298–302
Sobota JT (1991) The role of recombinant human erythropoietin in homologous transfusion avoidance. Contrib Nephrol 88: 334–348
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Aufricht, C., Ties, M., Salzer-Muhar, U. et al. Erythropoietin, erythropoesis and iron status in children after major surgical stress. Eur J Pediatr 154, 458–461 (1995). https://doi.org/10.1007/BF02029355
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02029355