Erythropoietin in the critically ill
The issues surrounding red blood cell (RBC) transfusion are important in the critically ill. Anaemia is very common in the critically ill; almost 95% of patients admitted to the intensive care unit (ICU) have a haemoglobin level below normal by ICU day 3 . As a result, critically ill patients receive a significant number of RBC transfusions during their ICU stay. Studies almost a decade ago found that over 50% of all patients admitted to the ICU were transfused during their ICU stay . Among patients with a prolonged ICU stay (greater than 1 week), 85% received a transfusion . On average, these latter patients were each transfused with over 9 units of RBCs during their ICU admission. These transfusions were not restricted to the early ICU course, but rather were transfused at a rate of 2 to 3 units per week. In a descriptive study of critical care units in the United States , on a single day almost 14% of patients in critical care units are transfused (ranging from 4% in CCUs to 27% in SICUs).
KeywordsIntensive Care Unit Stay Critical Care Unit Recombinant Human Erythropoietin Intensive Care Unit Discharge Prolonged Intensive Care Unit Stay
Unable to display preview. Download preview PDF.
- 5.Corwin HL, Abraham E, Fink MP et al (2001) Anemia and blood transfusion in the critically ill: current clinical practice in the US—The CRIT Study (abstract). Crit Care Med 29 ( Suppl ): A2Google Scholar
- 6.Vincent JL, Baron JF, Gattinoni L et al (2002) Anemia and blood transfusions in the critically ill: An epidemiological. Observational study. JAMA 288: 1499–1507Google Scholar
- 12.Frede S, Fandrey J, Pagel H et al (1997) Erythropoieitn gene expression is suppressed after lipopolysaccharide or interluekin- I B injections in rats. Am J Physiol 272: R1067–1071Google Scholar
- Blick M Sherwin SA. Rosenblum M, Guttterman J (1987) Phase I study of recombinant tumor necrosis factor in cancer patients. Cancer Res 47:2986–2989Google Scholar
- 17.Keating EM (1998) Current options and approaches for blood management in orthopedic surgery. J Bone Joint Surg Am 80: 750–762Google Scholar
- 18.Canadian Orthopedic Perioperative Erythropoietin Study Group (1993) Effectiveness of perioperative recombinant human erythropoietin in elective hip replacement. Lancet 341: 1227–1232Google Scholar
- 20.De Andrade JR, Jove M, Landon G et al (1997) Baseline hemoglobin as a predictor of risk of transfusion and response to epoetin alfa in orthopedic surgery patients. Am J Orthop 25: 533–542Google Scholar
- 29.Silver M, Bazan A, Corwin HL et al (2003) A randomized double blind placebo controlled trial of recombinant human erythropoietin in long term acute care patients. Crit Care Med 31 (Suppl): A 167Google Scholar