tailieunhanh - Báo cáo hóa học: " Erythropoietin in the intensive care unit: beyond treatment of anemia"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa hoc quốc tế đề tài : Erythropoietin in the intensive care unit: beyond treatment of anemia | Patel et al. Annals of Intensive Care 2011 1 40 http content 1 1 40 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access Erythropoietin in the intensive care unit beyond treatment of anemia Nimesh SA Patel1 Massimo Collino2 Muhammad M Yaqoob1 and Christoph Thiemermann1 Abstract Erythropoietin EPO is the major hormone stimulating the production and differentiation of red blood cells. EPO is used widely for treating anemia of critical illness or anemia induced by chemotherapy. EPO at pharmacological doses is used in this setting to raise hemoglobin levels by preventing the apoptosis of erythroid progenitor cells and is designed to reduce patient exposure to allogenic blood through transfusions. Stroke heart failure and acute kidney injury are a frequently encountered clinical problem. Unfortunately in the intensive care unit advances in supportive interventions have done little to reduce the high mortality associated with these conditions. Tissue protection with EPO at high nonpharmacological doses after injury has been found in the brain heart and kidney of several animal models. It is now well known that EPO has anti-apoptotic effects in cells other than erythroid progenitor cells which is considered to be independent of EPOs erythropoietic activities. This review article summarizes what is known in preclinical models of critical illness and discusses why this does not correlate with randomized controlled clinical trials. Introduction Inflammation renal failure or blood loss due to frequent phlebotomies gastric stress bleeding coagulation disorders or surgical procedures 1 often results in anemia in patients attending the intensive care unit ICU . It is well established that the bone marrow of critically ill patients is able to respond to exogenously administered erythropoietin EPO to cause a significant increase in reticulocyte count and serum transferrin receptor concentration 2 . However during the past two decades .