ERYTHROPOIETIN RESPONSE IS BLUNTED IN CRITICALLY ILL PATIENTS

Objectives: Critically ill patients often develop anaemia which can be related to a number of factors. However, the exact causes of anaemia in many patients remain unexplained. We hypothesized that the relation ship between erythropoietin (EPO) and haematocrit may be altered in cr itically ill patients. Design: Serum concentrations of EPO were serial ly determined by the ELISA method in 36 critically ill, non-hypoxaemic patients who stayed more than 7 days in the Intensive Care Unit, incl uding 22 patients with sepsis and 14 without. Eighteen ambulatory pati ents with iron-deficiency anaemia served as a control group. Setting: Two University Hospital Intensive Care Departments. Results: A signifi cant inverse correlation between serum EPO and haematocrit levels was found in the control patients (r = -0.81, p < 0.001), but not in the c ritically ill patients (r = -0.09, NS), except in a subgroup of non-se ptic patients without renal failure (r = -0.61, p < 0.01). Conclusions : EPO levels can be inappropriately low in critically ill patients, so that EPO deficiency may contribute to the development of anaemia in t hese patients. This phenomenon is observed not only in the presence of acute renal failure, but also in the presence of sepsis.