OBJECTIVE The purpose of this study was to determine if the number of red blood cell (RBC) transfusions anemic pediatric intensive care unit patients receive could be reduced by the prophylactic administration of recombinant human erythropoietin (rHuEPO).

METHODS This was a randomized, double-blind placebo controlled trial. Patients were randomized to receive either intravenous rHuEPO 300 units/kg/day or placebo. Both groups received elemental iron 6 mg/kg/day.

RESULTS Twenty-seven patients, ages 1 month to 13 years, were enrolled. Baseline hematocrit (Hct), reticulocyte count, and erythropoietin concentration were similar between the two groups. Three patients randomized to rHuEPO received 1 RBC transfusion each, and 4 patients randomized to placebo received 9 transfusions total (P = .68). The end-of-study Hct was not significantly different between the rHuEPO and placebo groups, 30.3 ± 3.6 and 26.8 ± 4.8, respectively (P = .06). Additionally, neither the % Hct change (baseline to final), nor the % reticulocyte change (baseline to final), was statistically different between the two groups.

CONCLUSION In this small group of anemic pediatric intensive care unit patients, prophylactic rHuEPO administration did not reduce the number of patients who received RBC transfusions. Furthermore, it did not significantly increase Hct or reticulocyte count when compared to placebo.

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