High-dose recombinant human erythropoietin stimulates reticulocyte production in patients with multiple organ dysfunction syndrome.
OBJECTIVE
To investigate erythropoietin (EPO) production and the erythropoietic potency of recombinant human EPO in the multiple organ dysfunction syndrome.


METHODS
Randomized, prospective, controlled clinical trial.


METHODS
Patients received either 600 IU/kg intravenous EPO three times weekly (n = 9) or saline (control, n = 10).


METHODS
EPO levels, circulating soluble receptors for tumor necrosis factor and interleukin-2, levels of interleukin-6 and intercellular adhesion molecule, and early peripheral blood cell progenitors.


RESULTS
EPO production in the control group remained low. Pharmacologic EPO blood levels were associated with increased reticulocyte counts compared with both controls (p < 0.04) and baseline (p < 0.006). Increased levels of soluble receptors for tumor necrosis factor in the treatment group compared with the controls did not prevent this effect. Interleukin 6 inhibited reticulocyte production.


CONCLUSIONS
Despite increased cytokine levels, pharmacologic EPO blood levels were associated with increased reticulocyte counts in patients with multiple organ dysfunction syndrome.
Gabriel
A
A
Department of Anesthesiology and General Intensive Care, General Hospital (AKH) of the University of Vienna, Austria.
Kozek
S
S
Chiari
A
A
Fitzgerald
R
R
Grabner
C
C
Geissler
K
K
Zimpfer
M
M
Stockenhuber
F
F
Bircher
N G
NG
D016207:Cytokines / Q000097:blood; D004906:Erythrocyte Count; D015672:Erythroid Precursor Cells / Q000187:drug effects; D004921:Erythropoietin / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000188:drug therapy*; D011446:Prospective Studies; D011994:Recombinant Proteins; D012156:Reticulocytes / Q000187:drug effects
D016207:Cytokines; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron