Pharmacokinetics and effectiveness of recombinant erythropoietin administered to preterm infants by continuous infusion in total parenteral nutrition solution - 12/10/17
Abstract |
OBJECTIVES: To compare the pharmacokinetics and effectiveness of continuously administered recombinant erythropoietin (Epo) in total parenteral nutrition (TPN) solution with daily subcutaneously administered Epo. METHODS: Forty preterm infants in the first 72 hours of life were randomly assigned to receive Epo (200 units/kg per day for 10 consecutive days), either subcutaneously (20 infants, 1051 ± 40 gm, 28.3 ± 0.4 weeks of gestation; mean ± SEM), or added daily to their TPN fluids (20 infants, 1028 ± 36 gm, 27.9 ± 0.4 weeks of gestation). Both groups received iron supplementation (1 mg/kg per day iron dextran in the TPN solution). Absolute reticulocyte counts and complete blood cell counts with differentials were measured, and transfusions and phlebotomy losses were recorded. Pharmacokinetics were determined in the first 16 infants. RESULTS: In the infants who received Epo subcutaneously, the elimination half-life was 17.6 ± 4.4 hours on day 3 and 11.2 ± 1.5 hours on day 10; the volume of distribution was 802 ± 190 ml/kg on day 3 and 1330 ± 243 m/kg on day 10. Serum Epo concentrations were higher on day 3 than on day 10 for both groups (subcutaneous: 400 ± 64 mU/ml vs 177 ± 29 mU/m, p <0.05; TPN: 395 ± 64 vs 194 ± 41 mU/ml, p <0.05). Clearance did not differ between the two groups with regard to route of administration and increased significantly from days 3 to 10 in both groups. Reticulocyte counts were similar in both groups. There were no differences between groups in the number of transfusions given, and the overall decline in hematocrit was similar. No adverse effects of Epo were noted in either group. CONCLUSIONS: Adding Epo to the TPN solution in this population results in similar Epo concentrations, clearance, and effectiveness as subcutaneous dosing. (J PEDIATR 1996;128:518-23)
Le texte complet de cet article est disponible en PDF.Abbreviations : Epo, TPN, ke
Plan
From the Divisions of Neonatology and Department of Pharmacy, University of Florida, Gainesville, and the Division of Neonatology, University of New Mexico, Albuquerque |
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Supported by grants No. HD-00988 and No. HL-44951 from the National Institutes of Health, and an award from The Children's Miracle Network Telethon. |
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Reprint requests: Robin K. Ohls, MD, University of New Mexico School of Medicine, Department of Pediatrics, ACC 3-W, Albuquerque, NM 87131-5313. |
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0022-3476/96/$5.00 + 0 9/20/71668 |
Vol 128 - N° 4
P. 518-523 - avril 1996 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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