Administration of Recombinant Erythropoietin Determines Increase of Peripheral Resistances in Patients with Hypovolemic Shock

Allegra, Alessandro; Galasso, Anselmo; Siracusano, Luca; Aloisi, Carmela; Corica, Francesco; Laganà, Angela; Frisina, N; Buemi, Michele

doi:10.1159/000189352

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…Regarding the pulmonary resistance, in a previous study, Allegra et al [25] , using a catheter placed in the pulmonary artery, performed a hemodynamic evaluation in 2 patients with hypovolemic shock. EPO administration caused an increase in the pulmonary vascular resistance and in the mean PAP.…”

Section: Ph: the Erythropoietin (Epo) Rolementioning

confidence: 99%

“…Remodeling operated by endothelial progenitor cells [17] In vivo effect on the PAP of polycythemia [21] Structural adaptation to hematological viscosity enhancement [18,20] Acute EPO administration in shocked rats [23] Interstitial and perivascular fibrosis [29] Upregulation of EPO receptor in the lung vessels [30] Clinical Models Acute EPO administration in shocked humans [25] Acute EPO administration in chronic cor pulmonale [26] …”

Section: Animal Modelsmentioning

confidence: 99%

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Pulmonary Hypertension and Erythropoietin

Buemi

Senatore²,

Gallo³

et al. 2007

Kidney Blood Press Res

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Numerous uremic patients on hemodialysis have pulmonary hypertension attributable to the presence of arteriovenous fistulas, vascular calcification, and endothelial dysfunction due to alterations in the balance between vasoconstrictive and vasodilatory substances. For these reasons, the effects of recombinant human erythropoietin, a drug widely used in patients on dialysis, on the pulmonary circulation were studied. Some authors maintain that recombinant human erythropoietin has an antihypertensive effect, while others have observed that this hormone induces a reduction in pulmonary arterial pressure due to its vasoactive and stimulatory effects on endothelial and smooth muscle cell precursors.

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Section: Ph: the Erythropoietin (Epo) Rolementioning

confidence: 99%

Section: Animal Modelsmentioning

confidence: 99%

Pulmonary Hypertension and Erythropoietin

Buemi

Senatore²,

Gallo³

et al. 2007

Kidney Blood Press Res

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“…In healthy male volunteers and in male patients with cor pulmonale, an I.V. EPO bolus (70 IU kg −1 ) was followed by an increase in the pulmonary vascular resistance index (measured with a Swan-Ganz catheter), suggested to be mediated by vasoconstriction (Allegra et al 2005), and in two patients with hypovolaemic shock a similar effect was reported (Allegra et al 1996). The effect of EPO on HPV was not tested in these studies, and in healthy subjects potential acute effects of EPO on the pulmonary vasculature are not documented.…”

mentioning

confidence: 60%

Erythropoietin does not have effects on the ventilatory and pulmonary vascular response to acute hypoxia in men and women

Berendsen

Lindeman

Boom

et al. 2016

Experimental Physiology

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New Findings r What is the central question of this study?Does a clinically relevant intravenous dose of erythropoeitin affect the hypoxic ventilatory response and/or hypoxic pulmonary vasoconstriction in healthy humans? r What is the main finding and its importance?Erythropoeitin does not influence the ventilatory and pulmonary vascular responses to acute hypoxia in men or women.Sustained and chronic hypoxia lead to an increase in pulmonary ventilation (hypoxic ventilatory response, HVR) and to an increase in pulmonary vascular resistance (hypoxic pulmonary vasoconstriction, HPV). In this study, we examined the effect of a clinical i.v. dose of recombinant human erythropoietin (50 IU kg −1 ) on the isocapnic HVR and HPV in seven male and seven female subjects by exposing them to hypoxia for 20 min (end-tidal P O 2 ß50 mmHg) while measuring their ventilation and estimating pulmonary arterial pressure from the maximal velocity of the regurgitant jet over the tricuspid valve during systole ( P max ) with echocardiography. In the placebo session, after 5 and 20 min men responded with an increase in ventilation by 0.0056 and 0.0023 l min −1 kg −1 %S pO 2 −1 , respectively, indicating the presence of hypoxic ventilatory depression. In women, the increase in ventilation was 0.0067 and 0.0047 l min −1 kg −1 %S pO 2 −1 , respectively. In both sexes, erythropoietin did not alter these responses significantly. In the placebo session, mean P max increased by 6.1 ± 0.7 mmHg in men (P = 0.035) and by 8.4 ± 1.4 mmHg in women (P = 0.020) during the hypoxic exposure, whereby women had a ß5 mmHg lower end-tidal P CO 2 . Erythropoietin did not alter these responses; in men, P max increased by 7.5 ± 1.1 mmHg (n.s. versus placebo) and in women by 9.7 ± 2.2 mmHg (n.s. versus placebo). We conclude that women tended to have a greater HPV in placebo conditions and that a clinical dose of erythropoietin has no effect on the HVR and HPV in either sex.

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“…In a study on anesthetized rats with hemorrhagic shock induced by intermittent bleeding from the iliac artery, the administration of rHuEPO was found to significantly increase the mean arterial pressure, the survival time and the percentage of animals that survived with respect to the non-treated control animals [160]. An increase in peripheral vascular resistence, mean arterial pressure and oxygen saturation was, moreover, found in patients with severe hypovolemic shock [161]. However, the survival of treated rats appears closely correlated with the capacity of the heart to adapt to the post-load due to the increase in pressure.…”

Section: Erythropoietin and Shockmentioning

confidence: 99%

From the Oxygen to the Organ Protection: Erythropoietin as Protagonist in Internal Medicine

Buemi¹,

Nostro²,

Giacobbe³

et al. 2006

CHAMC

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Erythropoietin (EPO), already known as the stimulating hormone for erythropoiesis, has shown different and interesting pleiotropic actions. It does not only affect erythroid cells, but also myeloid cells, lymphocytes and megakaryocytes. This hormone can also enhance phagocytic function of the polymorphonuclear cells and reduce the activation of macrophages, thus modulating the inflammatory process.Moreover, hematopoietic and endothelial cells probably have the same cellular origin, and the discovery of erythropoietin receptors (EPO-R) also on mesangial and myocardial cells, smooth muscle fibrocells and neurons has prompted the study of the non-erythropoietic functions of this hormone.The interaction between EPO and VEGF may be of particular importance in neovascularization and wound healing. Different studies have demonstrated that EPO has an important direct hemodynamic and vasoactive action, which does not depend exclusively on any increase in hematocrit and viscosity. Moreover EPO showed protective effects on myocardial cells against apoptosis induced by ischemia/repefusion injury, but it could negatively affect pulmonary hypertension in patient with chronic cor pulmonale.This review aims to stress the importance of the increasing interest in EPO applications and the necessity of further studies to gain a deeper knowledge of this hormone and its pleiotropic and complex actions.

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Administration of Recombinant Erythropoietin Determines Increase of Peripheral Resistances in Patients with Hypovolemic Shock

Cited by 10 publications

References 6 publications

Pulmonary Hypertension and Erythropoietin

Pulmonary Hypertension and Erythropoietin

Erythropoietin does not have effects on the ventilatory and pulmonary vascular response to acute hypoxia in men and women

From the Oxygen to the Organ Protection: Erythropoietin as Protagonist in Internal Medicine

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