Administración precoz de eritropoyetina en el prematuro extremo, ¿factor de riesgo de la retinopatía del prematuro? / Early administration of erythropoietin in the extreme premature, a risk factor for retinopathy of prematurity?

Introducción: La eritropoyetina (EPO) estimula la angiogénesis y podría favorecer la retinopatía del prematuro (ROP). El objetivo fue determinar si la EPO más hierro (Fe) administrada a partir del quinto día de vida era un factor de riesgo independiente para el desarrollo de ROP y su gravedad. Pacientes y métodos: 718 prematuros supervivientes con peso al nacer (PN) ≤1.500g o edad gestacional (EG) ≤32 semanas (y 6 días), ingresados entre 2001 y 2008. Los objetivos de SaO2 durante estos años fueron mantenerla entre el 88 y el 93%. El tratamiento con EPO se inició a los 5–7 días de vida, a 250UI/kg/3 veces a la semana vía subcutánea, asociada a Fe 5–6mg/kg/día, hasta las 34 semanas de edad corregida o el alta. Resultados: 493 prematuros (68,7%) no presentaron ROP, 139 (19,4%) tuvieron una ROP grado 1, 50 (7,0%) una grado 2 y 36 (5,0%) una grado 3. 27 precisaron láser. Una mayor gravedad de la ROP se asoció con menor PN y EG, más patología neonatal y mayor agresividad terapéutica (duración de la oxigenoterapia o ventiloterapia, número de transfusiones de hematíes). Los factores de riesgo asociados de manera independiente y significativa con la presencia de cualquier estadio de ROP fueron: menor PN, ausencia de cesárea, administración de EPO y necesidad de transfusión de hematíes. La administración de EPO aumentó 2,4 veces el riesgo de ROP, pero la influencia de la EPO sólo se observó en la aparición de ROP grado 1 (odds ratio: 5,50). Conclusiones: La administración de EPO+Fe se asocia y quizás favorece la aparición de ROP grado 1 (AU)

Introduction: Erythropoietin (EPO) stimulates angiogenesis and may favour the appearance of retinopathy of prematurity (ROP). The objective was to determine if EPO+Fe administered from the 5th day of life could be an independent risk factor for ROP appearance and its severity. Patients and method: The study included 718 preterm newborns with a birth weight ≤1,500g or a gestational age ≤32 weeks (and 6 days), admitted between 2001 and 2008. During these years, the target SaO2 was between 88% and 93%. EPO treatment began at 5–7 days of life, with a dose of 250 UI/Kg, 3 times a week, subcutaneously, together with Fe, 5–6mg/kg/day, both until 34 weeks of corrected age or discharge. Results: A total of 493 preterms (68.7%) did not have ROP, 139 (19.4%) had a grade 1 ROP, 50 (7.0%) a grade 2 ROP and 36 (5.0%) a grade 3 ROP. Laser therapy was required by 27 severe ROP was associated with lower birth weight and gestational age, more neonatal morbidity and a more aggressive treatment (duration of oxygen supplements or mechanical ventilation, number of blood transfusions). Risk factors independently and significantly associated with any ROP grade were: lower birth weight, no caesarean section, EPO administration and need for blood transfusion. EPO administration increased the risk of ROP by 2.4, but this only happened in case of grade 1 ROP (OR: 5.50). Conclusions: EPO+Fe administration is associated and perhaps stimulates the appearance of grade 1 ROP (AU)

[Early administration of erythropoietin in the extreme premature, a risk factor for retinopathy of prematurity?]. / Administración precoz de eritropoyetina en el prematuro extremo, ¿factor de riesgo de la retinopatía del prematuro?

INTRODUCTION: Erythropoietin (EPO) stimulates angiogenesis and may favour the appearance of retinopathy of prematurity (ROP). The objective was to determine if EPO+Fe administered from the 5th day of life could be an independent risk factor for ROP appearance and its severity. PATIENTS AND METHOD: The study included 718 preterm newborns with a birth weight ≤1,500g or a gestational age ≤32 weeks (and 6 days), admitted between 2001 and 2008. During these years, the target SaO2 was between 88% and 93%. EPO treatment began at 5-7 days of life, with a dose of 250 UI/Kg, 3 times a week, subcutaneously, together with Fe, 5-6mg/kg/day, both until 34 weeks of corrected age or discharge. RESULTS: A total of 493 preterms (68.7%) did not have ROP, 139 (19.4%) had a grade 1 ROP, 50 (7.0%) a grade 2 ROP and 36 (5.0%) a grade 3 ROP. Laser therapy was required by 27 severe ROP was associated with lower birth weight and gestational age, more neonatal morbidity and a more aggressive treatment (duration of oxygen supplements or mechanical ventilation, number of blood transfusions). Risk factors independently and significantly associated with any ROP grade were: lower birth weight, no caesarean section, EPO administration and need for blood transfusion. EPO administration increased the risk of ROP by 2.4, but this only happened in case of grade 1 ROP (OR: 5.50). CONCLUSIONS: EPO+Fe administration is associated and perhaps stimulates the appearance of grade 1 ROP.

Afectación sistémica en prematuros tras administración intranasal de un colirio de tetrizolina / Systemic involvement in premature infants after intranasal administration of tetryzoline drops

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