NEONATAL ANEMIA--PATHOPHYSIOLOGY AND TREATMENT

我们计划的组织主题是新生儿贫血，其 病因、表现、发病和治疗。我们有两个 战略目标：第一，减少同源红细胞数量 (RBC)新生儿患者接受的输血；第二，实现 不可避免的输血的最佳收益风险比。我们会 通过检查导致这些目标的生理机制来解决这些目标 通过为新生儿贫血建立健全的科学标准 通过探索治疗方法来检测临床上有意义的贫血 在绵羊模型中，通过比较重组人促红细胞生成素 不同水平输血的生理效应 红细胞压积，通过修改现有的血库技术来允许长时间- 一名献血者提供长期红细胞支持，并通过开发一种 安全测量红细胞体积和存活率的非放射性方法 新生儿。我们的计划整合了四个相互关联的项目 目标，取决于校长之间的协作关系 调查人员，并共享人员和资源。项目1，“对 《新生儿时期的贫血》使用了一个绵羊模型来关注差异 新生儿贫血与成人贫血的比较及新生儿和成人的差异 成人对促红细胞生成素治疗的反应。项目2，“非放射性物质 红细胞体积和存活率方法，将开发和验证一种生物素 将应用于人类婴儿的标签方法。项目3，“红色” 血细胞输注治疗早产儿贫血“将调查 新生儿贫血的生理学效应与婴儿的生理学 对输血的反应。项目#4，“单一--安全和可行性-- 捐献者计划“将开发和测试创新的血库技术 为了确定从单一捐赠者那里获得并为UP储存的红细胞 到六周后，可以安全地给婴儿输液。调查人员和 来自儿科、病理学、药理学、放射学和解剖学的顾问 将在这些项目中进行合作。我们节目的主题是 尤其重要，因为新生儿是最严重的 所有患者组均接受输血。在38,000名早产儿中， 出生体重和体重每年1500克在美国出生，80%将收到 在早期生命中平均有10次红细胞输注--占近 每年输血30万次。因此，我们研究的信息将是 与新生儿学实践有直接关系，并将提供 为继续研究围产期造血、血液学和 输血医学。

The organizing theme of our Program is anemia in the neonatal patient, its etiology, manifestations, morbidities and treatments. We have two strategic goals: first, to reduce the number of homologous red blood cell (RBC) transfusions that neonatal patients receive; and second, to achieve the optimal benefit-to-risk ratio for unavoidable transfusions. We will address these goals by examining the physiological mechanisms that lead to neonatal anemia, by establishing sound scientific criteria for the detection of clinically significant anemia, by exploring therapy with recombinant human erythropoietin in an ovine model, by comparing the physiological effects of transfusions given at different levels of hematocrit, by modifying current blood banking techniques to permit long- term RBC support by a single blood donor, and by developing a nonradioactive method for safely measuring RBC volume and survival in neonates. Our Program integrates four projects that have inter-related aims, depend upon collaborative relations among the principal investigators, and share personnel and resources. Project #1, "Response to Anemia During Neonatal Period," uses an ovine model to focus on differences between anemic neonates and adults and on the differences in neonatal and adult responses to erythropoietin therapy. Project #2, "A Nonradioactive Method for RBC Volume and Survival," will develop and validate a biotin labeling method that will be applied to human infants. Project #3, "Red Blood Cell Transfusions for Anemia of Prematurity," will investigate the physiological effects of neonatal anemia and the infant's physiological responses to transfusion. Project #4, "Safety and Feasibility of Single- Donor Programs," will develop and test innovative blood banking techniques to establish whether RBCs, obtained from a single donor and stored for up to six weeks, can be safely transfused to infants. Investigators and consultants from Pediatrics, Pathology, Pharmacology, Radiology and Anatomy will collaborate in these projects. The theme of our Program is particularly important because neonates are among the most heavily transfused of all patient groups. Of the 38,000 premature neonates with birth weight <1500 g born annually in the United States, 80% will receive an average of ten RBC transfusions during early life--accounting for nearly 300,000 transfusions per year. Thus, information from our studies will be of immediate interest to the practice of neonatology and will provide a basis for continued research in perinatal hematopoiesis, hematology and transfusion medicine.