HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Luca Weltert Stefano D'Alessandro Saverio Nardella Fabiana Girola Alessandro Bellisario Daniele Maselli Ruggero De Paulis Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weltert, L. Articles by De Paulis, R. Search for Related Content PubMed Articles by Weltert, L. Articles by De Paulis, R.

J Thorac Cardiovasc Surg 2010;139:621-627
© 2010 The American Association for Thoracic Surgery

Acquired Cardiovascular Disease

Preoperative very short-term, high-dose erythropoietin administration diminishes blood transfusion rate in off-pump coronary artery bypass: A randomized blind controlled study

Cardiac Surgery Department, European Hospital, Rome, Italy

Received for publication April 30, 2009; revisions received September 9, 2009; accepted for publication October 4, 2009.

^_* Address for reprints: Luca Weltert, MD, Cardiac Surgery Department, European Hospital, Rome, Italy. (Email: lweltert{at}gmail.com).

Objective: Human recombinant erythropoietin has been used to obtain a rapid increase in red blood cells before surgery. Previously, the shortest preparatory interval has been 4 days, but at the European Hospital only 2.4 days on average separate hospitalization and surgery. We therefore proposed a randomized blind trial to test the efficacy of high-dose erythropoietin for very short-term administration.

Methods: All patients presenting with a diagnosis of isolated coronary vessel disease were randomized to either erythropoietin therapy or a control group. Patients with a creatinine level greater than 2 mg/dL or hemoglobin level greater than 14.5 g/dL were excluded. Hemoglobin values were collected preoperatively and on postoperative days 1 and 4. Blood loss and blood transfusion rate were recorded at the time of discharge.

Results: We enrolled 320 consecutive patients in the study. No significant difference was found in preoperative parameters, postoperative blood loss, or mean preoperative hemoglobin levels. On postoperative day 4, mean hemoglobin was 15.5% higher in the erythropoietin group (10.70 ± 0.72 g/dL vs 9.26 ± 0.71 g/dL; P < .05). This group required 0.33 units of blood per patient, whereas the controls required 0.76 units per patient (risk ratio 0.43, P = .008).

Conclusion: A significant reduction in transfusion rate and a significant increase in hemoglobin values were observed in the erythropoietin group. No adverse events related to erythropoietin administration were recorded. A very short preoperative erythropoietin administration seems to be a safe and easy method to reduce the need for blood transfusions.

This article has been cited by other articles:

				L. D. Hillis, P. K. Smith, J. L. Anderson, J. A. Bittl, C. R. Bridges, J. G. Byrne, J. E. Cigarroa, V. J. DiSesa, L. F. Hiratzka, A. M. Hutter Jr, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., December 6, 2011; 58(24): e123 - e210. [Full Text] [PDF]

				Writing Committee Members, L. D. Hillis, P. K. Smith, J. L. Anderson, J. A. Bittl, C. R. Bridges, J. G. Byrne, J. E. Cigarroa, V. J. DiSesa, L. F. Hiratzka, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Circulation, December 6, 2011; 124(23): e652 - e735. [Full Text] [PDF]

				J. B. Williams, B. Phillips-Bute, S. D. Bhattacharya, A. A. Shah, N. D. Andersen, B. Altintas, B. Lima, P. K. Smith, G. C. Hughes, and I. J. Welsby Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest J. Thorac. Cardiovasc. Surg., May 1, 2011; 141(5): 1283 - 1288. [Abstract] [Full Text] [PDF]

				V. A. Ferraris, J. R. Brown, G. J. Despotis, J. W. Hammon, T. B. Reece, S. P. Saha, H. K. Song, E. R. Clough, L. J. Shore-Lesserson, L. T. Goodnough, et al. 2011 Update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines Ann. Thorac. Surg., March 1, 2011; 91(3): 944 - 982. [Abstract] [Full Text] [PDF]