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Supplemental Iron and Recombinant Erythropoietin for Anemia in Infants Born Very Preterm: A Survey of Clinical Practice in Europe

A Survey of Clinical Practice in Europe
Authors: Reibel-Georgi, Nora J; Scrivens, Alexandra; Heeger, Lisanne E; Lopriore, Enrico; New, Helen V; Deschmann, Emöke; Stanworth, Simon J; +18 Authors

Supplemental Iron and Recombinant Erythropoietin for Anemia in Infants Born Very Preterm: A Survey of Clinical Practice in Europe

Abstract

To survey practices of iron and recombinant human erythropoietin (rhEpo) administration to infants born preterm across Europe.Over a 3-month period, we conducted an online survey in 597 neonatal intensive care units (NICUs) of 18 European countries treating infants born with a gestational age of <32 weeks.We included 343 NICUs (response rate 56.3%) in the survey. Almost all NICUs (97.7%) routinely supplement enteral iron, and 74.3% of respondents to all infants born <32 weeks of gestation. We found that 65.3% of NICUs routinely evaluate erythropoiesis and iron parameters beyond day 28 after birth. Most NICUs initiate iron supplementation at postnatal age of 2 weeks and stop after 6 months (34.3%) or 12 months (34.3%). Routine use of rhEpo was reported in 22.2% of NICUs, and in individual cases in 6.9%. RhEpo was mostly administered subcutaneously (70.1%) and most frequently at a dose of 250 U/kg 3 times a week (44.3%), but the dose varied greatly between centers.This survey highlights wide heterogeneity in evaluating erythropoietic activity and iron deficiency in infants born preterm. Variation in iron supplementation during infancy likely reflects an inadequate evidence base. Current evidence on the efficacy and safety profile of rhEpo is only poorly translated into clinical practice. This survey demonstrates a need for standards to optimize patient blood management in anemia of prematurity.

Keywords

Male, Iron/administration & dosage, Iron, 610 Medicine & health, Recombinant Proteins/therapeutic use, Intensive Care Units, Neonatal, Surveys and Questionnaires, Anemia, Neonatal/drug therapy, very low birth weight infant, Humans, Practice Patterns, Physicians'/statistics & numerical data, 2735 Pediatrics, Perinatology and Child Health, recombinant human erythropoietin, Practice Patterns, Physicians', Erythropoietin, Anemia, Neonatal, prematurity, Infant, Newborn, 10027 Clinic for Neonatology, Infant, premature, Recombinant Proteins, Erythropoietin/therapeutic use, Europe, Infant, Extremely Premature, Health Care Surveys, Female, Intensive care units, neonatal, neonate, Infant, Premature

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Top 10%
Average
Green
hybrid