Effect of blood transfusion versus erythropoietin injection on peripheral erythropoietic response in burnt patients

الملخص EN

Severe anemia commonly occurs following extensive burns.

Multiple transfusions are routinely given to patients with large burn surface area, which carry the risk of development of several complications.

Objective: To evaluate the value of giving recombinant human erythropoietin (r-HuEPO) to burned patients.

Design: Prospective single center study.

Methods: Twenty-seven adult burned patients (burn size 20-40% of total body surface area) were included.

The studied patients were blindly and randomly assigned into two groups.

Group A(15 patients) received blood transfusion according to their need while group B (Inpatients) received 4000 units of r-HuEPO twice weekly for one month.

Blood transfusion was given to both groups when hemoglobin level decreased less than 8 gm/dl.

The effect of administered blood transfusion or r-HuEPO was evaluated through clinical response, blood count, reticulocytic count, serum iron, and transferrin and erythropoietin level.

Results: Mean values of hemoglobin, packed red cell volume and RBCs count of both groups were progressively decreased especially in the 3rd post burn day.

Despite the progressive decrease of all the previous hematological values in both groups, they had elevated serum erythropoietin level all over the post burn period which was significantly higher in group B.

Moreover, significant reticulocytosis was observed especially in group B.

Before administration of either blood transfusion or r-Hu EPO, serum iron levels were within normal range then rapidly reached extremely low levels and remained low throughout the study days in group B.

On the contrary, in group A serum iron levels were rapidly increased and reached high levels and remained high throughout the study.

Moreover, serum ferritin levels were rapidly reaching supernormal values and remained higher allover the study but the level of transferrin was low in the follow up days compared with that of the first days.

Conclusions: Recombinant human erythropoietin (r-Hu EPO) is capable of enhancing erythropoiesis and has lower risk of iron overload than frequent blood transfusions in burned patients