Ventré C, Rousseau S, Albanèse J, Leone M, Martin C
Département d'anesthésie et de réanimation, centre de traumatologie, AP-HM, CHU Nord, chemin des Bourrelys, 13915 Marseille cedex 20, France.
Ann Fr Anesth Reanim. 2004 Jul;23(7):714-21. doi: 10.1016/j.annfar.2004.02.053.
To analyze the data from the literature on erythropoietin and the future indications of recombinant human erythropoietin in intensive care unit (ICU) patients.
References were obtained from computerized bibliographic research (Pubmed) from 1986 to 2003, except for some physiologic data.
Original articles, reviews, and letters to editor in French and English were selected and analyzed.
An anemia is often observed in patients hospitalized in ICU. This anemia may be due to many reasons. The management of anemia consists on the treatment of the underlying disease associated with the transfusion of red blood cells. Recent studies provided evidence of an association between transfusions and mortality in ICU patients. The anemia of ICU patients is compared to the anemia of chronic diseases, which is characterized by a blunted erythropoietin. A treatment with rHuEPO may be a future therapeutic of the anemia in such patients. A multicentric study shows the efficacy of recombinant erythropoietin therapy on a decrease in the use of red blood cell, and another clinical trial highlights a decrease of the proportion of ICU patients receiving red blood cell. Recombinant erythropoietin could be an alternative to transfusion in certain conditions and certain ICU patients. Further studies are needed to determine the consequences on mortality rate and to clarify the place of this therapy in ICU patients.
分析有关促红细胞生成素的文献数据以及重组人促红细胞生成素在重症监护病房（ICU）患者中的未来应用指征。
除一些生理数据外，参考文献通过1986年至2003年的计算机文献检索（PubMed）获得。
选取并分析了法语和英语的原创文章、综述以及致编辑的信件。
在ICU住院的患者中经常观察到贫血。这种贫血可能由多种原因引起。贫血的处理包括治疗与输注红细胞相关的基础疾病。最近的研究提供了证据表明输注与ICU患者的死亡率之间存在关联。ICU患者的贫血与慢性病贫血相比较，其特点是促红细胞生成素反应迟钝。用重组人促红细胞生成素（rHuEPO）治疗可能是这类患者贫血的未来治疗方法。一项多中心研究显示重组促红细胞生成素疗法在减少红细胞使用方面的疗效，另一项临床试验突出显示接受红细胞的ICU患者比例下降。在某些情况下和某些ICU患者中，重组促红细胞生成素可能是输血的替代方法。需要进一步研究以确定对死亡率的影响，并阐明这种疗法在ICU患者中的地位。
