title: Erythropoietin does not have effects on the ventilatory and pulmonary vascular response to acute hypoxia in men and women.
abstract: What is the central question of this study? Does a clinically relevant intravenous dose of erythropoeitin affect the hypoxic ventilatory response and/or hypoxic pulmonary vasoconstriction in healthy humans? What is the main finding and its importance? Erythropoeitin does not influence the ventilatory and pulmonary vascular responses to acute hypoxia in men or women. Sustained and chronic hypoxia lead to an increase in pulmonary ventilation (hypoxic ventilatory response, HVR) and to an increase in pulmonary vascular resistance (hypoxic pulmonary vasoconstriction, HPV). In this study, we examined the effect of a clinical i.v. dose of recombinant human erythropoietin (50 IU kg-1) on the isocapnic HVR and HPV in seven male and seven female subjects by exposing them to hypoxia for 20 min (end-tidalPO2∼50 mmHg) while measuring their ventilation and estimating pulmonary arterial pressure from the maximal velocity of the regurgitant jet over the tricuspid valve during systole (ΔPmax) with echocardiography. In the placebo session, after 5 and 20 min men responded with an increase in ventilation by 0.0056 and 0.0023 l min-1kg-1%SpO2-1, respectively, indicating the presence of hypoxic ventilatory depression. In women, the increase in ventilation was 0.0067 and 0.0047 l min-1kg-1%SpO2-1, respectively. In both sexes, erythropoietin did not alter these responses significantly. In the placebo session, mean ΔPmaxincreased by 6.1 ± 0.7 mmHg in men (P = 0.035) and by 8.4 ± 1.4 mmHg in women (P = 0.020) during the hypoxic exposure, whereby women had a ∼5 mmHg lower end-tidalPCO2. Erythropoietin did not alter these responses; in men, ΔPmaxincreased by 7.5 ± 1.1 mmHg (n.s. versus placebo) and in women by 9.7 ± 2.2 mmHg (n.s. versus placebo). We conclude that women tended to have a greater HPV in placebo conditions and that a clinical dose of erythropoietin has no effect on the HVR and HPV in either sex.
authors.affiliation: Leiden University Medical Center, Department of Anesthesiology, Leiden, The Netherlands.
authors.forename: Remco R
authors.initials: RR
authors.lastname: Berendsen
authors.affiliation: Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Rob C
authors.initials: RC
authors.lastname: Lindeman
authors.affiliation: Leiden University Medical Center, Department of Anesthesiology, Leiden, The Netherlands.
authors.forename: Merel
authors.initials: M
authors.lastname: Boom
authors.affiliation: Leiden University Medical Center, Department of Anesthesiology, Leiden, The Netherlands.
authors.forename: Leon P H J
authors.initials: LPHJ
authors.lastname: Aarts
authors.affiliation: Leiden University Medical Center, Department of Anesthesiology, Leiden, The Netherlands.
authors.forename: Eveline L A
authors.initials: ELA
authors.lastname: van Dorp
authors.affiliation: Leiden University Medical Center, Department of Anesthesiology, Leiden, The Netherlands.
authors.forename: Luc J
authors.initials: LJ
authors.lastname: Teppema