ABSTRACT
The optimum dosage of subcutaneous (s.c.) epoetin alfa was assessed in a double-blind study in 31 patients scheduled for cardiac surgery. Patients received a total of four doses of either epoetin alfa 150 IU/kg (n = 11), epoetin alfa 300 IU/kg (n = 10), or placebo (n = 10) administered as single s.c. injections at weekly intervals starting 23 days prior to surgery. AB was collected with isovolemic replacement prior to each of the first three doses of medication. During the AB donation period, Hb levels decreased significantly (P < .05) from baseline to surgery in the placebo group (16.5%), compared with no significant decrease in either of the epoetin alfa groups (8.1% and 9.7% in the 150 IU/kg and 300 IU/kg groups, respectively). In addition, the difference between groups with regard to the decrease in Hb level reached statistical significance (P < .05) for the 150 IU/kg group versus placebo. Epoetin alfa treatment was also associated with significantly higher reticulocyte counts and serum erythropoietin levels in the preoperative period compared with placebo.
Subject(s)
Blood Transfusion, Autologous , Cardiac Surgical Procedures , Erythropoiesis/drug effects , Erythropoietin/pharmacology , Blood Transfusion/statistics & numerical data , Blood Transfusion, Autologous/statistics & numerical data , Dose-Response Relationship, Drug , Epoetin Alfa , Erythropoietin/administration & dosage , Humans , Injections, Subcutaneous , Iron/administration & dosage , Postoperative Complications , Premedication , Recombinant Proteins , Treatment OutcomeABSTRACT
The efficacy of a total hip replacement with a hydroxyapatite-coated hip prosthesis was compared with that of an uncoated, cementless prosthesis of the same type. Preoperatively, there was no difference in the patient's diagnosis, hip score, age, and sex. All operations were performed by one surgeon in a standardized manner. The choice of the implant was randomized, and the follow-up period was equal for both types. The implant used was associated with a poor outcome due to a high incidence of early aseptic loosening. Probably because of a poor initial fixation, there was a significant difference in the clinical results after a short follow-up period when an additional HA layer was used. According to the patients' pain, migration of the implant, and presence of a progressive radiolucent line, use of the HA-coated prosthesis led to a significantly better result; however, we also found an increased rate of heterotopic bone formation in the HA-coated group. It was concluded that the HA coating improves the initial fixation of a hip prosthesis.