Use of Erythropoietin in Patients with Injury and Blood Loss

Objective: to study whether anemia may be corrected with recombinant erythropoietin (EPO) in patients with severe concomitant injury and acute blood loss. Subjects and methods. The investigation included 78 patients with severe concomitant injury. The basic inclusion criterion was a hemoglobin level of 60 to 110 g/l. The concentration of endogenous EPO, hematological parameters, volume of blood transfusions, the number of thromboembolic events, and the results of treatment were analyzed in patients receiving EPO in addition to standard therapy. Not later than 2 days after admission, EPO (Epocrin) was given in a single intravenous dose of 40000 IU. Results. Within the first week after injury (but within the first 24 hours), the level of endogenous EPO was not above the background physiological values despite remaining anemia. Administration of EPO on day 1 day after injury was not followed by a clinically relevant hematopoietic effect. That on day 2 following injury produced a noticeable hematopoietic effect as elevated hemoglobin levels on days 9 to 14 of the follow-up. The use of recombinant EPO caused a 35% reduction in the need for blood preparations and no increase in the incidence of thrombotic and thromboembolic events. Conclusion. The peak hematopoietic effect was achieved by EPO given on day 2 after injury. The single administration of EPO in a dose of 40000 IU in this period induced an increase in hemoglobin levels on days 9 to 17, which decreased the need for blood transfusions, without affecting the incidence of thrombotic events. Key words: anemia, hypoxia, erythropoietin, blood transfusion, injury.