Does erythropoietin affect the outcome and complication rates of patient with traumatic brain injury? A pooled-analysis

Li, Yuping; Zhang, Jun; Wang, Haili; Zhu, Lei; Zhang, Hengzhu; Ma, Qiang; Liu, Xiaoguang; Lu, Guangyu

doi:10.1007/s10072-022-05877-4

Cited by 5 publications

(2 citation statements)

References 54 publications

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“…Erythropoietin (EPO) is a potential neuroprotectant with effects on many organ systems and has thoroughly been investigated in clinical and experimental TBI. A recent meta-analysis of 10 RCTs of 2402 TBI patients suggested a reduced mortality with EPO [41 ▪▪ ]. However, EPO has a poor blood-brain barrier penetration and rather mixed efficacy in available RCTs.…”

Section: Red Blood Cell Transfusion and Erythropoietinmentioning

confidence: 99%

The management of severe traumatic brain injury in the initial postinjury hours – current evidence and controversies

Hossain,

Rostami,

Marklund

2023

Current Opinion in Critical Care

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Purpose of review To provide an overview of recent studies discussing novel strategies, controversies, and challenges in the management of severe traumatic brain injury (sTBI) in the initial postinjury hours. Recent findings Prehospital management of sTBI should adhere to Advanced Trauma Life Support (ATLS) principles. Maintaining oxygen saturation and blood pressure within target ranges on-scene by anesthetist, emergency physician or trained paramedics has resulted in improved outcomes. Emergency department (ED) management prioritizes airway control, stable blood pressure, spinal immobilization, and correction of impaired coagulation. Noninvasive techniques such as optic nerve sheath diameter measurement, pupillometry, and transcranial Doppler may aid in detecting intracranial hypertension. Osmotherapy and hyperventilation are effective as temporary measures to reduce intracranial pressure (ICP). Emergent computed tomography (CT) findings guide surgical interventions such as decompressive craniectomy, or evacuation of mass lesions. There are no neuroprotective drugs with proven clinical benefit, and steroids and hypothermia cannot be recommended due to adverse effects in randomized controlled trials. Summary Advancement of the prehospital and ED care that include stabilization of physiological parameters, rapid correction of impaired coagulation, noninvasive techniques to identify raised ICP, emergent surgical evacuation of mass lesions and/or decompressive craniectomy, and temporary measures to counteract increased ICP play pivotal roles in the initial management of sTBI. Individualized approaches considering the underlying pathology are crucial for accurate outcome prediction.

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Section: Red Blood Cell Transfusion and Erythropoietinmentioning

confidence: 99%

The management of severe traumatic brain injury in the initial postinjury hours – current evidence and controversies

Hossain,

Rostami,

Marklund

2023

Current Opinion in Critical Care

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“…Проведено большое число экспериментальных работ, определивших роль ЕРО для нормального роста и развития плода [10,14,15]. Таким образом, ЕРО признан плюрипотентным гликопротеином, который в головном мозге препятствует действиям гипоксии-ишемии, окислительного стресса и развивающимся на их фоне воспалению, апоптозу, проявляя нейротропные и нейропротекторные свойства, участие в ангио-, нейро-и олигодендрогенезе [16][17][18][19].…”

Section: Introductionunclassified

Diagnostic Value of Erythropoietin Levels in Umbilical Cord Blood in Hypoxic-Ischemic Brain Injury: Clinical Observational Cross-Sectional Study

Berezhanskaya

Abduragimova

2022

Kuban. nauсh. med. vestnik

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Background. In recent years erythropoietin has received particular attention due to the discovery of its important non-haematological effects. Erythropoietin is recognized as a pluripotent glycoprotein, manifesting neurotropic and neuroprotective properties as well as participating in angio-, neuro- and oligodendrogenesis, interferes with the effects of hypoxia-ischemia, oxidative stress and associated with them inflammation and apoptosis in the brain. During fetal hypoxia, the dominant production of erythropoietin switches to the placenta, starting its active synthesis to protect the brain, heart and other vital organs from harmful effects of severe hypoxia.Objectives. The study was aimed at determining the correlation between the severity of hypoxic ischemic brain injury and erythropoietin level in the artery and vein of the umbilical cord.Methods. A clinical observational cross-sectional study was conducted on the basis of the Maternity Hospital, Neonatal Pathology and Pediatric Departments №1 and №2 of the Research Institute of Obstetrics and Pediatrics under the auspices of Rostov State Medical University, Russian Federation. The study included 184 newborns with moderate (group II, n = 78) and severe hypoxic ischemic injury of the central nervous system (group III, n = 42). Group I consisted of 64 children without signs of central nervous system injury in the early neonatal period. Among which, following the maternal medical histories, 40 newborns were allocated to the group with the apparent development of delayed manifestation of neurological pathology. The evaluation of erythropoietin concentration in the umbilical cord blood was conducted separately in the artery and vein with Erythropoietin-EIA-BEST, a set of reagents for the enzyme-linked determination of erythropoietin concentration in the blood serum. Statistical analysis was carried out via MS Excel 2019 (Microsoft, USA), Statistica 12.5, (IBM, USA), SPSS27.001.Results. Erythropoietin concentrations in the blood of the artery and vein of the umbilical cord in the groups of newborns were determined according to the severity of hypoxic-ischemic brain injury. The authors of the study showed the correlation between the “maternal-placental-fetal” blood flow at 36–40 weeks of gestation, which parameters are important antenatal predictors of the central nervous system injury, and the values of erythropoietin in arterial and venous umbilical cord blood as diagnostic markers.Conclusion. The severity of cerebral abnormalities is determined by a high level of erythropoietin, while a decrease in erythropoietin level with severe cerebral deficit can mark a disabling injury.

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Letter to the Editor: does erythropoietin affect the outcome and complication rates of patient with traumatic brain injury? A pooled analysis

Zheng

Luo

2022

Neurol Sci

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Does erythropoietin affect the outcome and complication rates of patient with traumatic brain injury? A pooled-analysis

Cited by 5 publications

References 54 publications

The management of severe traumatic brain injury in the initial postinjury hours – current evidence and controversies

The management of severe traumatic brain injury in the initial postinjury hours – current evidence and controversies

Diagnostic Value of Erythropoietin Levels in Umbilical Cord Blood in Hypoxic-Ischemic Brain Injury: Clinical Observational Cross-Sectional Study

Letter to the Editor: does erythropoietin affect the outcome and complication rates of patient with traumatic brain injury? A pooled analysis

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