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Erythropoetin in der Neonatologie

Erythropoietin in neonatology

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Zusammenfassung

In der Neonatologie wird Erythropoetin (EPO) in erster Linie zur Behandlung der Frühgeborenenanämie eingesetzt. Obwohl der transfusionseinsparende Effekt der Erythropoetintherapie evident ist, ist das tatsächliche Einsparungspotenzial niedrig und klinisch von geringer Bedeutung. Auch gibt es keine optimale therapeutische Strategie hinsichtlich des Zeitpunkts, des Beginns und der Dauer der Erythropoetintherapie, der Dosierung von Erythropoetin und Eisen sowie der Applikationsformen. Erythropoetin besitzt neben der erythropoetischen Komponente auch antiapoptotisches Potenzial in diversen anderen Organen. Ein möglicher neuer Therapieansatz ist, es als Neuroprotektivum einzusetzen – hier gibt es aus der Erwachsenmedizin bereits viel versprechende Daten bei Schlaganfallpatienten. Ein weiteres klinisches Einsatzgebiet in der Neonatologie ist die Prophylaxe der nekrotisierenden Enterokolitis (NEC).

Abstract

In neonatology eythropoietin (EPO) is used primarily for the treatment of anaemia of prematurity. EPO has an obvious effect in the reduction of transfusion requirements, but the clinical importance of this reduction is marginal. There is also no consensus on the optimal therapeutic strategy, in terms for example of timing and duration of EPO administration, dosage of EPO and iron and mode of administration. Besides the erythropoetic components, EPO also also potential antiapoptotic effects in various other organs. One possible new therapeutic approach is the use of EPO as a neuroprotective agent; promising data on this use have been recorded in adult stroke patients. A further clinical use in neonatology is the prevention of necrotizing enterocolitis.

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Abbreviations

CHr:

Hämoglobingehalt des Retikulozyten

CPAP:

„continouus positive airway pressure“

EPO:

Erythropoetin

Hb:

Hämoglobin

Hkt:

Hämatokrit

NEC:

Nekrotisierende Enterokolitis

paw :

Mittlerer Atemwegsdruck

RDS:

„respiratory distress syndrome“

ROP:

„retinopathy of prematurity“ (Frühgeborenenretinopathie)

TfR:

Löslicher Transferrinrezeptor

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  1. Abteilung für Allgemeinpädiatrie und Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Währinger Gürtel 18–20, 1090, Wien, Österreich

    N. Haiden

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Correspondence to N. Haiden.

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Haiden, N. Erythropoetin in der Neonatologie. Monatsschr Kinderheilkd 155, 1131–1136 (2007). https://doi.org/10.1007/s00112-007-1617-3

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  • DOI: https://doi.org/10.1007/s00112-007-1617-3

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