title: High-dose recombinant human erythropoietin stimulates reticulocyte production in patients with multiple organ dysfunction syndrome.
abstract: 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.
authors.affiliation: Department of Anesthesiology and General Intensive Care, General Hospital (AKH) of the University of Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Gabriel
authors.forename: S
authors.initials: S
authors.lastname: Kozek
authors.forename: A
authors.initials: A
authors.lastname: Chiari
authors.forename: R
authors.initials: R
authors.lastname: Fitzgerald
authors.forename: C
authors.initials: C
authors.lastname: Grabner
authors.forename: K
authors.initials: K
authors.lastname: Geissler
authors.forename: M
authors.initials: M
authors.lastname: Zimpfer
authors.forename: F
authors.initials: F
authors.lastname: Stockenhuber
authors.forename: N G
authors.initials: NG
authors.lastname: Bircher
mesh_terms: 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
chemical_list: D016207:Cytokines; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron