ERYTHROPOIETIN, ERYTHROPOESIS AND IRON STATUS IN CHILDREN AFTER MAJORSURGICAL STRESS

The aim of our study was to evaluate bone marrow stimulation and bone marrow response to postoperative 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, tra nsferrin saturation and C-reactive protein were assessed perioperative ly after cardiopumonary bypass for surgical repair of atrial septal de fect. 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-fol d from 11.1 +/- 3.1 (6-19) to 18.4 +/- 5.9 (10-31) parts per thousand (P < 0.05). Transferrin saturation was inversely correlated to C-react ive protein. Conclusion These findings suggest adequate bone marrow st imulation but an inadequate bone marrow response during the immediate perioperative period, caused by inhibition of erythropoesis by acute p ostoperative inflammation in children after open heart surgery.