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Enhancing Red Blood Cells in Prostatectomy Judged Safe

Study finds giving ESPs preoperatively doesn't increase cardiovascular or thromboembolic risks

MONDAY, June 14 (HealthDay News) -- The use of erythropoietin stimulating proteins (ESPs) in men with normal hemoglobin levels undergoing open radical retropubic prostatectomy is not associated with an increase in cardiovascular or thromboembolic complications, according to a study in the June issue of Urology.

Herbert Lepor, M.D., of the New York University School of Medicine in New York City, and colleagues measured the hematocrit levels at baseline, immediately before anesthesia, and at hospital discharge for 1,308 men who underwent open radical retropubic prostatectomy, including 1,095 men who received preoperative ESPs. The men were followed for the incidence of thromboembolic and cardiovascular complications during their hospitalization and following the surgery.

Among the men receiving ESPs, the researchers found that the mean change in preoperative hematocrit level was 5.9 g/dL, and the mean hospital discharge hematocrit level was 33.6 g/dL. The hematocrit level before anesthesia induction was 49.2 percent. The researchers found that the risks of cardiovascular and thromboembolic complications in men receiving ESP were 0.55 and 0.45 percent, respectively, with the risk independent of the change in preoperative hematocrit or the absolute level of the pre-anesthesia induction hematocrit.

"We continue to recommend ESPs as a very sensible preoperative blood management strategy for men undergoing open radical retropubic prostatectomy as it reduces both the risk of allogeneic transfusion equivalent to autologous blood donation and facilitates recovery by increasing the discharge hematocrit," the authors write.

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