Use of erythropoietin and its effects on blood lactate and 2,3-diphosphoglycerate in premature neonates

The aim of this study was to investigate the effect of recombinant human er ythropoietin (rHu-EPO) on oxygen affinity and adequate oxygen delivery to t he tissues of stable premature infants. 36 very-low-birth-weight infants we re randomly assigned to either receive rHu-EPO (200 units/kg every other da y) or not, and both groups were supplemented with iron, folic acid and vita min E. Arterial blood gases, oxygen saturation, complete blood counts, feta l haemoglobin, 2,3-diphosphoglycerate (2,3-DPG) and blood lactate were anal ysed weekly, from the Ist week till discharge. Patients in the two groups w ere comparable. There was a trend in increasing lactate values towards the 4th to 5th weeks of life, which did not reach statistical significance. The re was no correlation between lactate values and the studied variables (pH, BE, oxygen saturation). In 35 transfusions, pre- and 24 h post-transfusion blood lactate status was studied. in 23 of them, a decrease in post-transf usion lactate was noticed, whilst an increased post-transfusion 'level was shown in 10 cases and no change in 2 cases. The mean pre-transfusion lactat e value was significantly higher than the post-transfusion one (24.04 +/- 1 1.9 mg/dl before and 16.27 +/- 8.5 mg/dl after transfusion; p = 0.0025). In both groups there was a steady rise in 2,3-DPG concentration over the peri od of study, and the 2,3-DPG values at the end of our study were significan tly increased in the rHu-EPO group (rHu-EPO 5.98 +/- 0.9, control 4.84 +/- 0.7; p = 0.04). In conclusion, the use of rHu-EPO did not affect blood lact ate levels compared to the control group. Regarding oxygen affinity, it see ms that rHu-EPO causes a shift of the oxy-haemoglobin dissociation curve to the right. This is a previously unreported effect of rHu-EPO and its clini cal use may, thus, confer to preterm babies an added advantage. Copyright ( C) 2000 S. Karger AG, Basel.