epoetin-alfa and Hemorrhage

Topics: Blood Specimen Collection; Blood Substitutes; Blood Transfusion; Critical Care; Epoetin Alfa; Erythropoietin; Hematinics; Hemorrhage; Hemostatics; Humans; Jehovah's Witnesses; Monitoring, Physiologic; Nurse's Role; Nursing Assessment; Oxygen Consumption; Recombinant Proteins; Risk Factors; Transfusion Reaction; Treatment Refusal

Topics: Algorithms; Epoetin Alfa; Erythropoietin; Hematinics; Hemorrhage; Humans; Intraoperative Complications; Liver Diseases; Pancreatic Diseases; Recombinant Proteins

Erythropoietin (EPO) has been linked to cardioprotective effects. However, its effects during the aging process are little known. We investigated the effect of EPO administration on hemodynamic parameters, cardiac function, oxidative damage, and erythropoietin receptor (EPOR) expression pattern in the hypovolemic state. EPO was administered (1000 IU/kg/3 days) and then acute hemorrhage (20% blood loss) was induced in young and adult rats. There was no difference in plasmatic EPO in either age group. The hemodynamic basal condition was similar, without alterations in renal function and hematocrit, in both age groups. After bleeding, both EPO-treated age groups had increased blood pressure at the end of the experimental protocol, being greater in adult animals. EPO attenuated the tachycardic effect. Ejection fraction and fractional shortening were higher in adult EPO-treated rats subjected to hemorrhage. In the left ventricle, young and adult EPO-treated rats subjected to bleeding showed an increased EPOR expression. A different EPOR expression pattern was observed in the adult right atrial tissue, compared with young animals. EPO treatment decreased oxidative damage to lipids in both age groups. EPO treatment before acute hemorrhage improves cardiovascular function during the aging process, which is mediated by different EPOR pattern expression in the heart tissue.

Topics: Age Factors; Animals; Cardiovascular System; Disease Models, Animal; Epoetin Alfa; Hematinics; Hemodynamics; Hemorrhage; Lipid Peroxidation; Male; Myocardium; Oxidative Stress; Rats, Sprague-Dawley; Receptors, Erythropoietin; Ventricular Function, Left

Recovery from blood loss requires a greatly enhanced supply of iron to support expanded erythropoiesis. After hemorrhage, suppression of the iron-regulatory hormone hepcidin allows increased iron absorption and mobilization from stores. We identified a new hormone, erythroferrone (ERFE), that mediates hepcidin suppression during stress erythropoiesis. ERFE is produced by erythroblasts in response to erythropoietin. ERFE-deficient mice fail to suppress hepcidin rapidly after hemorrhage and exhibit a delay in recovery from blood loss. ERFE expression is greatly increased in Hbb(th3/+) mice with thalassemia intermedia, where it contributes to the suppression of hepcidin and the systemic iron overload characteristic of this disease.

Topics: Anemia; Animals; beta-Thalassemia; Blotting, Western; Disease Models, Animal; Enzyme-Linked Immunosorbent Assay; Epoetin Alfa; Erythropoiesis; Erythropoietin; Gene Expression Profiling; Hemoglobins; Hemorrhage; Hepcidins; Hormones; Iron; Iron Overload; Liver; Male; Mice; Mice, Inbred C57BL; Mice, Knockout; Molecular Sequence Data; Real-Time Polymerase Chain Reaction; Recombinant Proteins; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger

Evaluation of the clinical efficacy and tolerance of metronomic chemotherapy as salvage therapy in a young patient with advanced, platinum resistant, ovarian carcinoma and bad performance status.. We tried palliative chemotherapy with daily low dose oral cyclophosphamide with a patient suffering from stage IIIC ovarian cancer that responded to daily cyclophosphamide (CTX) after no response to chemotherapy with paclitaxel and carboplatin as first line and progression after second line with topotecan. The progression-free survival time on daily low dose oral cyclophosphamide treatment was 65 months without side effects. She was well during the chemotherapy and lived a normal working and social life.. We think that use of low dose of oral CTX should be investigated further as a strategy against tumour progression after standard chemotherapy in patients who are platinum resistant with poor performance status.

Topics: Adult; Antineoplastic Agents, Alkylating; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Colonic Neoplasms; Colostomy; Cyclophosphamide; Cystadenocarcinoma, Serous; Disease-Free Survival; Drug Administration Schedule; Drug Evaluation; Drug Resistance, Neoplasm; Epoetin Alfa; Erythropoietin; Fatal Outcome; Female; Follow-Up Studies; Hemorrhage; Humans; Intestinal Obstruction; Karnofsky Performance Status; Laparotomy; Ovarian Neoplasms; Ovariectomy; Paclitaxel; Palliative Care; Peritoneal Neoplasms; Recombinant Proteins; Salvage Therapy; Topotecan; Urinary Bladder Neoplasms; Vitamins

Orthopedic trauma is a major source of morbidity and mortality in the United States and other countries. Major orthopedic trauma often results in significant blood loss, which is the most common cause of shock in the trauma setting. Transfusion of allogeneic blood and blood products may be used to maintain blood pressure but may not be the most effective therapy for the acute anemia that results from trauma-induced hemorrhage. Because acute anemia can interfere with successful and timely rehabilitation of these patients, it is important to be aggressive in treating anemia. One approach is to administer Epoetin alfa to stimulate erythropoiesis. A pilot study is currently in progress to test the efficacy of this approach in major trauma patients.

Topics: Blood Transfusion; Blood Transfusion, Autologous; Epoetin Alfa; Erythropoietin; Fractures, Bone; Hematinics; Hemorrhage; Humans; Recombinant Proteins

Following the successful replacement of diseased kidneys by renal homotransplants, regression of the anemia of chronic renal disease was found in five patients. Increased erythropoietic-stimulating activity was demonstrated in the serum of one patient seven weeks after renal transplantation when he suffered a severe hemorrhage. It is postulated that a renal homotransplant can produce enough erythropoietin to maintain a normal hemoglobin value and to respond to the stimulus of a sudden hemorrhage.

Topics: Anemia; Epoetin Alfa; Erythrocyte Count; Erythropoiesis; Erythropoietin; Hemoglobins; Hemorrhage; Humans; Kidney Diseases; Kidney Failure, Chronic; Kidney Transplantation; Male; Postoperative Complications; Reticulocytes; Transplantation, Homologous

The production of erythropoietin in dogs increased after they had been exposed to 300 rad of gamnma rays and then subjected to hemorrhage.

Topics: Animals; Dogs; Epoetin Alfa; Erythropoiesis; Erythropoietin; Hemorrhage; Radiation Effects; Research

Topics: Anemia; Animals; Bone Marrow Cells; Epoetin Alfa; Erythropoietin; Hemorrhage; In Vitro Techniques; Iron; Polycythemia; Rabbits; Research; Reticulocytes; Sheep; Stem Cells; Tritium

Topics: Anemia; Anemia, Hemolytic; Animals; Biomedical Research; Bone and Bones; Bone Marrow; Epoetin Alfa; Erythropoiesis; Erythropoietin; Hematocrit; Hemoglobinometry; Hemorrhage; Humans; Iron Isotopes; Liver; Male; Pharmacology; Phenylhydrazines; Physiology, Comparative; Rabbits; Rats; Research; Spleen

Topics: Animals; Epoetin Alfa; Erythropoietin; Hemorrhage; Phenylhydrazines; Sheep

Topics: Epoetin Alfa; Erythropoietin; Hemorrhage; Humans; Serum