Efficacy of Erythropoietin in treatment of anemia in patients hospitalized in the ICU of Ardabil city hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20183473Keywords:
Anemia, Erythropoietin, Intensive Care UnitAbstract
Background: Several studies have shown that approximately 95% of patients who have been admitted to the ICU are anemic. Anemia in acute patients leads to significant transfusion. Transfusion can lead to significant complications. Because of the risks of transfusion an alternative therapy for anemia in patients seems be a necessary need for its. The aim of this study was to investigate the efficacy of Erythropoietin in treatment of anemia in patients hospitalized in the ICU of Ardabil city hospital.
Methods: This study is a clinical trial. In this study after selection of patients based on inclusion and exclusion criteria, their data were entered in a check list. Patients were divided into two groups of 35 persons randomly. For first group, erythropoietin was administrated in addition of iron and in second group only iron was administrated. All patients were administrated 100 mg of iron. Hematological indexes and clinical status of patients was evaluated and results were analyzed by statistical methods in SPSS version 19.
Results: In this study, in cases 65.7% and in controls 71.4% were male. The average age of patients in cases was 61.6±20.8 and controls were 61.02±22.5 years. The mean duration of hospitalization in internal ICU was 37.73 days and in surgical ICU was 21.35 days and was observed that at baseline the hemoglobin levels in internal patients was lower than surgical patients (p=0.023). 80% of patients in case group (5.8 units) and 88.57% of patients in controls (6.3 units) required blood transfusion. The hemoglobin level in erythropoietin receiving group increased significantly compared to the control group.
Conclusions: The results of this study showed that erythropoietin is an effective drug to increase hemoglobin level and can provide a significant increase in hemoglobin level compared to placebo.Metrics
References
Blinder RM. Anemia and Transfusion therapy. In: Foster C, Mistry NF, Peddi PF, Sharma S. The Washington manual of medical therapeutics. 33rd Edition. Wolters kluwer /Lippincott Williams and Wilkins; 2010:713-747.
Prakash D. Anemia in the ICU: Anemia of chronic disease versus anemia of acute illness. Crit Care Clin. 2012;28(7):333-43.
Roberts DJ, Zygun DA. Anemia, red blood cell transfusion, and outcomes after sever traumatic brain injury. Crit Care. 2012;16(5):154.
Rodriguez RM, Corwin HL, Gettinger A, Corwin MJ, Gubler D, Pearl RG. Nutritional deficiencies and blunted erythropoietin response as causes of the anemia of critical illness. J Crit Care. 2001;16:36-41.
Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy AM, Abraham E, et al. The CRIT study: Anemia and blood transfusion in the critically ill: current clinical practice in the United States. Crit Care Med. 2004;32:39-52.
Van Iperen CE, Gaillard CM, Kraaijenhagen RJ, Braam BG, Marx JM, van de Wiel A. Response of erythropoiesis and iron metabolism to recombinant human erythropoietin in intensive care unit patients. Crit Care Med. 2000;28:2773-8.
Hebert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med. 1999;340:409-17.
Kopko PM. transfusion-related acute lung injury: pathophysiology, laboratory investigation, and donor management. Immunohematol. 2004;20:103-11.
MacLennan S, Williamson LM. Risks of fresh frozen plasma and platelets. J Trauma. 2006;60:S46-S50.
Volar AP, Maur AL, Binnekade JM, Schultz MJ, Juffermans NP. Determinants of transfusion decisions in a mixed medical-surgical intensive care unit: a prospective cohort study. Blood Transfus. 2009 Apr;7(2):106-10.
Gould S, Cimino MJ, Gerber DR. Packed red blood cell transfusion in the intensive care unit: limitations and consequences. Am J Crit Care. 2007;16(1):39-48.
Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Shapiro MJ. Efficacy of recombinant human erythropoietin in critically ill patients: a randomized controlled trial. JAMA. 2002;288:2827-35.
Georgopoulos D, Matamis D, Routsi C. Recombinant human erythropoietin therapy in critically ill patients: a dose-response study. Crit Care. 2005;9:R508-15.
Corwin H, Gettinger A. Efficacy of recombinant human erythropoietin in the critically ill patient: A randomized, double-blind, placebo-controlled trial. Crit Care. 2001;29:R518-12.
Fauci AS, Braunwald E. Harrison principles of internal medicin, 18th Ed, new york. MC Graw-hill; 2012.
Corwin HL, Gettinger A, Fabian TC, May A, Pearl RG, Heard S. Efficacy and safety of epoetin alfa in critically ill patients. N Engl J Med. 2007;357:965-76.
Shapiro MJ, Gettinger A, Corwin HL, Napolitano L, Levy M, Abraham E. Anemia and blood transfusion in trauma patients admitted to the intensive care unit. J Trauma. 2003;55:269-73.
Hecht D, Boujoukos A. Anemia in the ICU: are your patients needing erythropoetin? Critical Care. 2010;14:332.
Corwin HL, Gettinger A, Rodriguez RM, Pearl RG, Gubler KD, Enny C. Efficacy of recombinant human erythropoietin in the critically ill patient: a randomized, double-blind, placebo-controlled trial. Crit Care Med. 1999;27:2346-50.
Silver M, Corwin MJ, Bazan A, Gettinger A, Enny C, Corwin HL. Efficacy of recombinant human erythropoietin in critically ill patients admitted to a long-term acute care facility: a randomized, double-blind, placebo-controlled trial. Crit Care Med. 2006 Sep;34(9):2310-6.
Napolitano LM, Fabian TC, Kelly KM, Bailey JA, Block EF, Langholff W. Improved survival of critically ill trauma patients treated with recombinant human erythropoietin. J Trauma. 2008;65:285-97.