rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2012-5-11rmt-194Research ArticleТРАВМА. КРОВОПОТЕРЯINJURY. BLOOD LOSSПрименение эритропоэтина у больных с травмой и кровопотерейUse of Erythropoietin in Patients with Injury and Blood LossГерасимовЛ. В.GerasimovL.V.lev-gerasimov@ya.ruСаморуковВ. Ю.SamorukovV. Yu.-МорозВ. ВMorozV. V.-ИвановаГ. П.IvanovaG. P.-20122010201285Том VIII № 5 2012 г.1111Copyright © Герасимов Л.В., Саморуков В.Ю., Мороз В.В., Иванова Г.П., 20122012Герасимов Л.В., Саморуков В.Ю., Мороз В.В., Иванова Г.П.Gerasimov L., Samorukov V.Y., Moroz V.V., Ivanova G.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/194

Цель исследования — изучение возможности коррекции анемии у больных с тяжелой сочетанной травмой и острой кровопотерей при помощи рекомбинантного эритропоэтина. Материал и методы. В исследование включено 78 больных с тяжелой сочетанной травмой. Основной критерий включения в исследование — уровень гемоглобина от 60 до 110 г/л. Проанализированы концентрация эндогенного эритропоэтина, гематологические показатели, объем гемотрансфузий, количество тромбоэмболических осложнений и результаты лечения у больных, получавших эри-тропоэтин в дополнение к стандартной терапии. Эритропоэтин («Эпокрин») вводили не позже 2-х суток после поступления в дозе 40000 ЕД однократно в/венно. Результаты. В течение первой недели после травмы (за исключением первых суток) уровень эндогенного эритропоэтина не превышал фоновых физиологических значений, несмотря на сохраняющуюся анемию. Введение ЭПО в 1-е сутки после травмы не сопровождалось клинически значимым гемопоэтическим действием. При введении ЭПО на 2-е сутки после травмы развивался выраженный гемо-поэтический эффект в виде прироста уровня гемоглобина с 9-х по 14-е сутки наблюдения. Применение рекомбинантного эритропоэтина привело к снижению на 35% потребности в препаратах крови и не сопровождалось увеличением частоты развития тромботических и тромбоэмболических осложнений. Заключение. Максимальный гемопоэтический эффект достигается при введении ЭПО на вторые сутки после травмы. При однократном введении ЭПО в эти сроки в дозе 40000 ЕД отмечается прирост уровня гемоглобина с 9-х по 17-е сутки, что уменьшает потребность в гемотрансфузиях, не влияя при этом на частоту тромботических осложнений. Ключевые слова: анемия, гипоксия, эритропоэтин, гемотрансфузия, травма.

Objective: to study whether anemia may be corrected with recombinant erythropoietin (EPO) in patients with severe concomitant injury and acute blood loss. Subjects and methods. The investigation included 78 patients with severe concomitant injury. The basic inclusion criterion was a hemoglobin level of 60 to 110 g/l. The concentration of endogenous EPO, hematological parameters, volume of blood transfusions, the number of thromboembolic events, and the results of treatment were analyzed in patients receiving EPO in addition to standard therapy. Not later than 2 days after admission, EPO (Epocrin) was given in a single intravenous dose of 40000 IU. Results. Within the first week after injury (but within the first 24 hours), the level of endogenous EPO was not above the background physiological values despite remaining anemia. Administration of EPO on day 1 day after injury was not followed by a clinically relevant hematopoietic effect. That on day 2 following injury produced a noticeable hematopoietic effect as elevated hemoglobin levels on days 9 to 14 of the follow-up. The use of recombinant EPO caused a 35% reduction in the need for blood preparations and no increase in the incidence of thrombotic and thromboembolic events. Conclusion. The peak hematopoietic effect was achieved by EPO given on day 2 after injury. The single administration of EPO in a dose of 40000 IU in this period induced an increase in hemoglobin levels on days 9 to 17, which decreased the need for blood transfusions, without affecting the incidence of thrombotic events. Key words: anemia, hypoxia, erythropoietin, blood transfusion, injury.

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The authors declare that there are no conflicts of interest present.