Critically ill patients have been estimated to have transfusion requirements of between 1 and 2 units per week in the ICU. We previously demonstrated that the administration of rHuEPO at a dose of 450u/kg/wk SQ of was effective in decreasing the need for transfusions in critically ill patients. We prospectively evaluated the ability of a weight based weekly protocol of lower dose (300u/kg/wk) rHuEPO to similarly reduce the need for transfusions.
Patients were eligible for the protocol if they had an anticipated ICU length of stay of one week or greater and a Hct of < 28%. Protocol patients received 300u/kg/wk of rHuEPO. Transfusions were recorded beginning 7 days after entry. No transfusion protocol was implemented. All patients had transferrin levels measured upon entry and at two-week intervals with iron supplementation as indicated.
450 u/kg/wk rHuEPO*300u/kg/wk rHuEPOn5461Average age74.766.4Average # doses rHuEPO3.1(r1–10)3.0(r1–7)Average dose of rHuEPO28000 units22000 unitsPredicted transfusions167183Actual transfusions4571Units saved (% reduction)122(73%)112 (61%)*
Previously reported data
Weekly rHuEPO at doses of 300u/kg/wk has a comparable efficacy to 450u/kg/wk in reducing transfusions in critically ill patients.
Significant cost and medication savings can be realized by the utilization of rHuEPO at lower than previously described doses while still maintaining efficacy for reduction of transfusions.
L.C. Rotello, Ortho Biotech.Speakers Bureau