Abstract
The article presents the basics and con-trol of erythropoiesis in the fetus and the newborn, the development of anaemia of prematurity and its treatment, with an em-phasis on the use of human recombinant erythropoietin. The Intensive Care Unit of the Paediatric Clinic Maribor began treat-ing anaemia of prematurity with eryth-ropoietin in 2000. After introducing the treatment, the clinic found that the num-ber of blood product transfusions and the needed blood volume decreased. In addi-tion to erythropoietin, this was the result of stricter criteria for applying transfusion of concentrated erythrocytes.
Highlights
After birth, the transition from a hypoxic to a hyperoxic state in all newborns lowers haemoglobin (Hb) concentrations
The most significant factor behind non-physiological anaemia is insufficient excretion of EPO from the immature cells of the renal interstitium - the transition from the liver to renal production of EPO is late because it is not determined by chronological age but by gestational age. (11-14) In the first few months, preterm infants depend on the formation of EPO in the liver; because of their overly low sensitivity to hypoxia, the production of EPO is insufficient in spite of low Hb values
The non-physiological anaemia of the preterm infant, better known as the anaemia of prematurity (4-12 weeks after birth) appears mostly in preterm infants with very low birth weight (1,500 g or less) and is a time-limited, hyporegenerative, normocytic normochromic anaemia with decreased erythropoiesis in the bone marrow reflected in very low reticulocyte values in peripheral blood, while leukocyte and thrombocyte values are generally normal. (15-17) Haemoglobin concentration is under 70100 g/L, haematocrit is under 0.30; the child has clinical signs of anaemia such as poor weight gain, tiredness at feeding, tachypneas, dyspneas, tachycardia, apnoea attacks and metabolic acidosis
Summary
MIKSIĆ MIRJANA1, DUKIĆ VUKOVIĆ TANJA1, POGOREVC ROBERT1, TREIBER MILENA2 1 Clinical department of Paediatrics, Maribor University Medical Centre, Maribor, Slovenia 2 Clinical department of Gynaecology and Perinatology, Maribor University Medical Centre,Maribor, Slovenia
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