Efficacy and Safety of Epoetin Alfa in Critically Ill Patients

In this randomized, placebo-controlled trial, the investigators administered epoetin alfa or placebo to 1460 medical, surgical, or trauma patients between 48 and 96 hours after admission to the intensive care unit. Treatment with epoetin alfa did not reduce the percentage of patients receiving a red-cell transfusion (the primary outcome) but did appear to reduce mortality in patients with trauma. However, this therapy was also associated with an increase in the incidence of thrombotic events. Treatment with epoetin alfa did not reduce the percentage of patients in the intensive care unit receiving a red-cell transfusion, but did appear to reduce mortality in patients with trauma. Anemia is common in the critically ill, often resulting in red-cell transfusions. 1 , 2 Two observational studies reported that 35 to 45% of patients admitted to intensive care units (ICUs) receive transfusions of almost 5 red-cell units while in the ICU. 3 , 4 However, the view that red-cell transfusion is beneficial for critically ill patients has been questioned because of data suggesting that red-cell transfusion may decrease the likelihood of survival in critically ill adults. 5 – 8 Anemia is evident early in the courses of critical illnesses, and hemoglobin concentrations fall throughout stays in the ICU. 1 , 4 Impaired production of red cells contributes . . .