Abstract
Whether the low Hb observed at 1-2 mos. age in preterm infants truly represents an anemic state remains a controversy. In order to determine what factors appear to be most important in the regulation of tissue oxygenation during this period of life, 21 infants with birth wgts. <1500 were evaluated at day 14 and then every two weeks during their nursery stay. Studies obtained included: Hb, retic cts, fetal Hb, RBC 2,3 diphosphoglycerate, P50, oxygen consumption (VO2), arterial blood gas, cardiac output (Q) by echocardiography and plasma erythropoietin by RIA. PvO2 values were calculated from the information provided by the P50, PaO2, Hb, Q, and VO2. The derived PvO2 varied from 22 to 43 torr (mean= 32±5) while EP ranged from 4.5 to 26.2 mU/ml. No significant correlations were observed between EP and Q, VO2, PaO2, A-V oxygen content difference, or retic count. The EP did inversely correlate with the Hb level (r=-0.21, p<0.05). The most significant correlation obtained was between EP and PvO2 (r=-0.55,p<0.001). No elevations of EP were noted when the PvO2 >37 torr. Between 30-37 torr PvO2, the EP was ↑ in 10 of 25 instances while between 25 and 30 torr, 16 of 23 EP samples were elevated. The EP was uniformly ↑ when the PvO2 was <25 torr. These data indicate that the most important indicator of a need for a higher Hb in preterm infants is a low PvO2, the calculation of which reflects the balance of O2 delivery and O2 need.
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Stockman, J., Clark, D., Kavey, R. et al. 1443 ANEMIA OF PREMATURITY, ERYTHROPOIETIN (EP) AND CENTRAL VENOUS OXYGEN TENSION (PvO2), INDICATORS OF ADEQUATE TISSUE OXYGENATION. Pediatr Res 15 (Suppl 4), 683 (1981). https://doi.org/10.1203/00006450-198104001-01472
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DOI: https://doi.org/10.1203/00006450-198104001-01472