Recombinant Human Erythropoietin Use in Intensive Care

Darveau, Martin; Notebaert, Éric; Denault, André; Bélisle, Sylvain

doi:10.1345/1542-6270(2002)036<1068:rheuii>2.0.co;2

Cited by 3 publications

(5 citation statements)

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“…One group of authors suggest that additional studies are required to determine the efficacy of epoetin alfa in the critically ill patient. 97 Although we agree with this conclusion, we disagree with their ultimate conclusion and believe that administration of epoetin alfa in critically ill patients should be considered. A statistically significant reduction in overall blood use has been observed in critically ill patients treated with epoetin alfa.…”

Section: Future Directionsmentioning

confidence: 66%

Managing Anemia in the Critically Ill Patient

Rudis

Jacobi

Hassan³

et al. 2004

Pharmacotherapy

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Anemia of critical illness is a multifactorial condition caused by phlebotomy, ongoing blood loss, and inadequate production of red blood cells. It occurs early in the course of critical illness. Although red blood cell transfusion is the treatment of choice for immediate management of anemia in the intensive care unit, controversy surrounds the most appropriate hemoglobin concentration or hematocrit "trigger." Therapeutic options, including blood-conservation tools, minimization of phlebotomy, erythropoietic agents, and investigational oxygen-carrying agents, may be alternatives to red blood cell transfusions in critically ill patients with anemia. Patient selection for erythropoietic agents will depend on further work dealing with outcomes and the total cost of care in managing the anemia of critical illness.

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Section: Future Directionsmentioning

confidence: 66%

Managing Anemia in the Critically Ill Patient

Rudis

Jacobi

Hassan³

et al. 2004

Pharmacotherapy

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“…30 Similarly Darveau et al also concluded that rhEPO could not reduce the need for RBC transfusions in critically ill anemicpatient. 31 No critically ill neonates were evaluated in this study.…”

Section: Discussionmentioning

confidence: 99%

“…32 Shannon et al administered iron at 3mg/kg/day for all infants who were tolerating full enteral feedings. 31 Maier suggested that iron supplements in a dose of 2mg/kg/day might have been inadequate for optimal erythropoiesis. 33 Serum ferritin concentration presumably reflects adequate administration of iron and do not provide complete information about iron storage.…”

Section: Discussionmentioning

confidence: 99%

Effect of Oral Erythropoietin in Prevention of Anemia of Prematurity

Alam¹,

Khan

Nahar

et al. 2018

Bangladesh J Child Health

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Introduction: Anemia of prematurity (AOP) is a common problem of very low birth weight babies. Blood transfusion is a necessity when it occurs in moderate to Methods: This randomized controlled study conducted in the NICU of BSMMU over one year. Total 60 preterm (<34 weeks)VLBW (<1500g) infants were enrolled and randomly divided into Control (group-I), Oral (group-II) and Subcutaneous (group III). Experimental groups (group-II & group-III) received rhEPO 400 IU/Kg, 3 times weekly in oral and subcutaneous (S/C) route respectively and continued for 2 weeks (Total 6 doses). Therapy was initiated 14 days after birth when the baby achieved oral feeding of at least 50 ml/kg/day of breast milk. All infants received oral iron and folic acid

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“…Erythropoietin primarily stimulates the differentiation and proliferation of colony-forming units erythroid (CFU-E) (61). When endogenous erythropoietin concentration is abnormally low, exogenous administration prevents the destruction of CFU-E and increases RBC generation.…”

Section: A D Mi Ni S T Rat Io N Of Exo Ge No U S Erythropoietinmentioning

confidence: 99%

“…Erythropoietin may be administered subcutaneously or intravenously. Subcutaneous administration consistently provides physiologic serum concentrations but bioavailability is limited at 22-31%, peak serum concentrations may not occur for 5-24 h after administration, and serum half-life is prolonged (61,(66)(67)(68). Intravenous administration achieves steady-state serum concentrations quicker than subcutaneous administration but may produce supraphysiologic peak serum concentrations followed by subphysiologic concentrations.…”

Section: A D Mi Ni S T Rat Io N Of Exo Ge No U S Erythropoietinmentioning

confidence: 99%

Use of exogenous erythropoietin in critically ill patients

MacLaren¹,

Gasper²,

Jung³

et al. 2004

J Clin Pharm Ther

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Objective: Review the literature regarding the use of recombinant human erythropoietin (rHuEPO) to prevent red blood cell (RBC) transfusion in critically ill patients. Data sources: A computerized search of MEDLINE and EMBASE from 1966 through June 2003 was conducted using the terms erythropoietin, anemia, hemoglobin, critical care, intensive care, surgery, trauma, burn, and transfusion. References of selected articles were reviewed. A manual search of critical care, surgery, trauma, burn, hematology, and pharmacy journals was conducted to identify relevant abstracts. Results: Six randomized studies have evaluated exogenous administration of erythropoietin to prevent RBC transfusions in critically ill patients. Studies vary with respect to rHuEPO dosage regimens, dose of concurrently administered iron, patient characteristics, and transfusion thresholds. Administration of rHuEPO rapidly produces erythropoiesis to reduce the need for RBC transfusions. The largest study conducted to date used weekly rHuEPO administration and found a modest decrease in transfusion requirements although the time to first transfusion was delayed. Reduced intensive care unit (ICU) length of stay (LOS) was shown in only one study of surgical/trauma patients. Reduced LOS after ICU discharge was found in another study of severely ill patients (APACHE II score >22). Other clinical outcomes were not altered by rHuEPO use. No adverse events were associated with rHuEPO use although studies were not designed to evaluate safety.Conclusions: rHuEPO reduces the need for transfusions. A cost-effectiveness analysis of rHuEPO for this indication is needed. Defining an optimal dosage regimen, identifying patients most likely to respond to rHuEPO, and determining risk factors for ICU associated anaemia would provide information for appropriate rHu-EPO utilization.

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Recombinant Human Erythropoietin Use in Intensive Care

Cited by 3 publications

References 0 publications

Managing Anemia in the Critically Ill Patient

Managing Anemia in the Critically Ill Patient

Effect of Oral Erythropoietin in Prevention of Anemia of Prematurity

Use of exogenous erythropoietin in critically ill patients

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