Georgopoulos Dimitris, Matamis Dimitris, Routsi Christina, Michalopoulos Argiris, Maggina Nina, Dimopoulos George, Zakynthinos Epaminondas, Nakos George, Thomopoulos George, Mandragos Kostas, Maniatis Alice
Department of Intensive Care Medicine, University Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece.
Crit Care. 2005 Oct 5;9(5):R508-15. doi: 10.1186/cc3786. Epub 2005 Aug 5.
The aim of this study was to assess the efficacy of two dosing schedules of recombinant human erythropoietin (rHuEPO) in increasing haematocrit (Hct) and haemoglobin (Hb) and reducing exposure to allogeneic red blood cell (RBC) transfusion in critically ill patients.
This was a prospective, randomized, multicentre trial. A total of 13 intensive care units participated, and a total of 148 patients who met eligibility criteria were enrolled. Patients were randomly assigned to receive intravenous iron saccharate alone (control group), intravenous iron saccharate and subcutaneous rHuEPO 40,000 units once per week (group A), or intravenous iron saccharate and subcutaneous rHuEPO 40,000 units three times per week (group B). rHuEPO was given for a minimum of 2 weeks or until discharge from the intensive care unit or death. The maximum duration of therapy was 3 weeks.
The cumulative number of RBC units transfused, the average numbers of RBC units transfused per patient and per transfused patient, the average volume of RBCs transfused per day, and the percentage of transfused patients were significantly higher in the control group than in groups A and B. No significant difference was observed between group A and B. The mean increases in Hct and Hb from baseline to final measurement were significantly greater in group B than in the control group. The mean increase in Hct was significantly greater in group B than in group A. The mean increase in Hct in group A was significantly greater than that in control individuals, whereas the mean increase in Hb did not differ significantly between the control group and group A.
Administration of rHuEPO to critically ill patients significantly reduced the need for RBC transfusion. The magnitude of the reduction did not differ between the two dosing schedules, although there was a dose response for Hct and Hb to rHuEPO in these patients.
本研究旨在评估两种给药方案的重组人促红细胞生成素（rHuEPO）在提高危重症患者血细胞比容（Hct）和血红蛋白（Hb）水平以及减少异体红细胞（RBC）输注方面的疗效。
这是一项前瞻性、随机、多中心试验。共有13个重症监护病房参与，共纳入148例符合入选标准的患者。患者被随机分配接受单独静脉注射蔗糖铁（对照组）、静脉注射蔗糖铁和皮下注射rHuEPO 40000单位每周一次（A组）或静脉注射蔗糖铁和皮下注射rHuEPO 40000单位每周三次（B组）。rHuEPO至少给药2周，或直至从重症监护病房出院或死亡。治疗的最长持续时间为3周。
对照组输注的RBC单位累积数量、每位患者和每位接受输血患者的平均RBC单位输注数量、每天输注的RBC平均体积以及接受输血患者的百分比均显著高于A组和B组。A组和B组之间未观察到显著差异。从基线到最终测量，B组Hct和Hb的平均升高幅度显著大于对照组。B组Hct的平均升高幅度显著大于A组。A组Hct的平均升高幅度显著大于对照组个体，而对照组和A组之间Hb的平均升高幅度无显著差异。
对危重症患者给予rHuEPO可显著减少RBC输血需求。尽管这些患者中Hct和Hb对rHuEPO存在剂量反应，但两种给药方案的减少幅度并无差异。
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