Erythropoietin in ICU patients receiving early red blood cell transfusions: A retrospective study of the impact on transfusion requirements

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2025-03-19 DOI:10.1016/j.jcrc.2025.155052

Thomas Carpentier , Anthony Merlin , Arnaud Cappe , Matthieu Metzelard , Léonie Villeret , Patrick Jeanjean , Yazine Mahjoub , Julien Maizel , Hervé Dupont , Stéphanie Malaquin , Aurélien Mary

{"title":"Erythropoietin in ICU patients receiving early red blood cell transfusions: A retrospective study of the impact on transfusion requirements","authors":"Thomas Carpentier , Anthony Merlin , Arnaud Cappe , Matthieu Metzelard , Léonie Villeret , Patrick Jeanjean , Yazine Mahjoub , Julien Maizel , Hervé Dupont , Stéphanie Malaquin , Aurélien Mary","doi":"10.1016/j.jcrc.2025.155052","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Anemia correlates with increased ICU mortality; but the use of erythropoietin (EPO) as a treatment remains debated. We sought to assess EPO use in ICU severe anemia.</div></div><div><h3>Methods</h3><div>A retrospective single-center study was conducted in four adult ICUs. Inclusion criteria were ICU stay ≥10 days (to limit immortality bias) and RBC transfusion within the first 48 h (an indication of severe anemia likely to justify EPO). EPO contraindication was an exclusion criterion. Univariate tests were followed by a multivariable analysis.</div></div><div><h3>Results</h3><div>Over a 28-month period, 190 patients (69 with EPO) were included. EPO subgroups displayed had a higher prevalence of hemorrhagic shock and surgical ICU admissions. EPO administration was significantly associated with a lower requirement for late RBC transfusions in trauma and non-trauma subgroups, with odds ratios [95 % confidence interval] of 0.29 [0.10–0.85] and 0.03 [0.004–0.18], respectively. In the EPO subgroup, the median hemoglobin level rose by 1.2 g/dL. Cox model showed a significant association with mortality at day 28 and 365.</div></div><div><h3>Conclusion</h3><div>Our study supports the hypothesis whereby EPO administration in severely anemic ICU patients reduces late transfusion needs, with a potentially higher survival rate. Systematic EPO use post-RBC transfusion in ICU patients warrants further investigation.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155052"},"PeriodicalIF":3.2000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of critical care","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0883944125000395","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Anemia correlates with increased ICU mortality; but the use of erythropoietin (EPO) as a treatment remains debated. We sought to assess EPO use in ICU severe anemia.

Methods

A retrospective single-center study was conducted in four adult ICUs. Inclusion criteria were ICU stay ≥10 days (to limit immortality bias) and RBC transfusion within the first 48 h (an indication of severe anemia likely to justify EPO). EPO contraindication was an exclusion criterion. Univariate tests were followed by a multivariable analysis.

Results

Over a 28-month period, 190 patients (69 with EPO) were included. EPO subgroups displayed had a higher prevalence of hemorrhagic shock and surgical ICU admissions. EPO administration was significantly associated with a lower requirement for late RBC transfusions in trauma and non-trauma subgroups, with odds ratios [95 % confidence interval] of 0.29 [0.10–0.85] and 0.03 [0.004–0.18], respectively. In the EPO subgroup, the median hemoglobin level rose by 1.2 g/dL. Cox model showed a significant association with mortality at day 28 and 365.

Conclusion

Our study supports the hypothesis whereby EPO administration in severely anemic ICU patients reduces late transfusion needs, with a potentially higher survival rate. Systematic EPO use post-RBC transfusion in ICU patients warrants further investigation.

Abstract Image

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.