Recombinant human erythropoietin in severe anaemia: issues of dosing and duration.
The majority of Jehovah's Witnesses refuse blood product transfusion, even when it can be lifesaving. Treatment with recombinant human erythropoietin (RHuEPO) is a valuable adjunct in Jehovah's Witness patients undergoing surgery. A number of additional strategies, including acute normovolaemic haemodilution, intra-operative blood salvage and reinfusion, iron and folate supplementation are also utilized to avoid blood transfusion. Critically ill patients have blunted erythropoietin production and decreased endogenous iron availability. This case report reviews the treatment of anaemia in critically ill Jehovah's Witness patients after surgery and discusses the potential need for higher RHuEPO dosing strategies and longer duration of therapy.
Charles
A
A
Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Purtill
M
M
Napolitano
L M
LM
D000368:Aged; D000740:Anemia / Q000188:drug therapy*; D016063:Blood Loss, Surgical; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006400:Hematocrit / Q000379:methods; D006801:Humans; D033221:Jehovah's Witnesses / Q000523:psychology*; D009062:Mouth Neoplasms / Q000601:surgery; D011994:Recombinant Proteins; D012068:Religion and Medicine
D011994:Recombinant Proteins; D004921:Erythropoietin