Early high-dose erythropoietin therapy and hypothermia after out-of-hospital cardiac arrest: a matched control study.
OBJECTIVE
To test the possible neuroprotective effect of early high-dose erythropoietin-alpha (Epo-alpha) after out-of-hospital cardiac arrest (OHCA).


METHODS
A matched control study. Following resuscitation with mild hypothermia after OHCA, participants received a first dose of Epo-alpha followed by four additional injections within 48 h (40,000 IU intravenously each injection). Plasma Epo-alpha levels were measured at different time points. Outcome and adverse events were assessed up to day 28 and were compared with those of matched-paired controls.


RESULTS
In all 18 participants received Epo-alpha and were compared with 40 matched controls. Pharmacokinetic variables were similar to those previously reported for healthy people or for persons treated with usual dosages of Epo. At day 28, survival rates among the Epo-treated group and the controls (55% versus 47.5%, p=0.17) and rates of full neurological recovery (55% versus 37.5%) did not differ significantly. Incidences of thrombocytosis in the Epo-treated group and controls were 15% and 5%, respectively; an arterial vascular thrombosis was observed in one case (5%) from the Epo-treated cohort.


CONCLUSIONS
Among victims of OHCA treated with Epo-alpha and hypothermia, we observed a high survival rate, with no minor cerebral sequels but potential haematological side effects. Future studies of Epo should pay particular attention to these findings.
Cariou
Alain
A
Medical Intensive Care Unit, Cochin Hospital, Paris Cedex, France. alain.cariou@cch,aphp.fr
Claessens
Yann-Erick
YE
Pène
Frederic
F
Marx
Jean-Sebastien
JS
Spaulding
Christian
C
Hababou
Cyrla
C
Casadevall
Nicole
N
Mira
Jean-Paul
JP
Carli
Pierre
P
Hermine
Olivier
O
D000368:Aged; D016887:Cardiopulmonary Resuscitation; D004921:Erythropoietin / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007036:Hypothermia, Induced; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D010865:Pilot Projects; D011446:Prospective Studies; D020127:Recovery of Function; D016019:Survival Analysis; D013922:Thrombocytosis / Q000150:complications
D006454:Hemoglobins; D018696:Neuroprotective Agents; D004921:Erythropoietin