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Perfusion
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Use of erythropoietin in open heart surgery

Michael N D'Ambra

Harvard Medical School, Department of Anesthesia and Cardiac Anesthesia Group, Massachusetts General Hospital

Despite widespread efforts to reduce the need for homologous blood transfusion during and after cardiac surgery, most patients still do require transfusions. This may be explained in part by changing demographics (more elderly patients), more patients presenting for repeat operations, and improvements in surgical and anaesthetic technology that allow more complex and invasive procedures. Cardiac surgery-with the obligate haemodilution associated with cardiopulmonary bypass - presents a great challenge in blood conservation. Erythropoietin has a role in the pharmacological therapy of cardiac surgery because cardiopulmonary bypass is associated with endogenous erythropoietin deficiency. This report discusses the mechanisms of endogenous erythropoietin production, the effect of recombinant human erythropoietin therapy, and the role of this drug in specific cardiac surgical procedures and situations.

Perfusion, Vol. 8, No. 1 suppl, 13-20 (1993)
DOI: 10.1177/026765919300800103
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 Ann. Thorac. Surg.Home page
M. N. D'Ambra, R. J. Gray, R. Hillman, J. W. Jones, H. C. Kim, R. Rawitscher, H. Schnaper, I. Szymanski, G. J. Vlahakes, D. Kaplan, et al.
Effect of Recombinant Human Erythropoietin on Transfusion Risk in Coronary Bypass Patients
Ann. Thorac. Surg., December 1, 1997; 64(6): 1686 - 1693.
[Abstract] [Full Text]