Abstract 54

Objective: To investigate the effect of rHu-EPO on oxygen affinity and adequate oxygen delivery to the tissues of stable premature infants. Methods: 22 VLBW infants (G.A. ≤ 31 weeks, B.W. ≤ 1250g) were randomly assigned to either receive rHu-EPO (200 units/Kg/every other day) or not, and both groups were supplemented with iron, folic acid and vitamin E. Arterial blood gases, oxygen saturation, complete blood counts, HbF, 2,3DPG and blood lactate were analyzed weekly, from 1st week till discharge, whilst daily recordings on clinical state were made. Results: Patients in the two groups were comparable. No linear correlation between haematocrit and serum lactate was found in 196 serial measurements nor any other correlation could be demonstrated between the other variables (pH,BE,SaO2) studied. There was a trend in increasing lactate values towards the 4th-5th weeks of life, which did not reach statistical significance. The mean pre-transfusion lactate value was significantly higher than the post- transfusion one in both groups (rHu-EPO: pre- 23,78 ± 12,4, post- 14,6 ± 8,08, p=0.038; Control: pre- 27,6 ± 11,7, post- 17,35 ± 9,58, p=0,01). In 28 transfusions, pre- and 24hrs post- transfusion blood lactate status was studied. In 16 of them, a decrease in post-transfusion lactate was noticed, whilst an increased post-transfusion level was shown in the other 12 cases. In both groups there was a steady rise in 2,3 DPG concentration over the period of study and the 2,3 DPG values at the end of our study were significantly increased in the rHu-EPO group (rHu-EPO: 5,9 ± 0,41; Control: 5,1 ± 0,76; p=0,012). In conclusion, the use rHu-EPO did not affect blood lactate levels comparing to the control group. Regarding oxygen affinity, it seems that rHu-EPO causes a shift of the oxy-haemoglobin dissociation curve to the right. Additional studies are needed in order to establish the effect of rHu-EPO on oxygen affinity and determine its significance.