Anemia of Prematurity: An Individualized Approach

Introduction: Anemia of prematurity (AOP) is a frequent finding in very-low-birth-weight infants (VLBWIs). Impaired erythropoietin (EPO) production, reduced red blood cell life span, nutritional deficiencies, and phlebotomy losses are the mechanisms involved.1 Delayed cord clamping (DCC) and limiting phlebotomy losses are effective measures to prevent AOP.2,3 To avoid potential adverse effects, low transfusion thresholds are used in most recent blood transfusion (BT) protocols.4 Erythropoiesis-stimulating agents decrease the number of transfusions in VLBWIs, but their use is not universally accepted due to the partial clinical benefit and to the cost.5 In this report, we describe the protocol used in our NICU for management of AOP in VLBWIs. The main goal of the protocol is the prevention of anemia and individualized use of ßEPO.