Erythropoietin in the critically ill: what is the evidence?

In patients with chronic kidney disease receiving regular treatment with recombinant erythropoietins (rHuEPO or epoetins), infection and inflammation may lead to erythropoietin resistance and loss of efficacy. During episodes of acute illness there is variability in practice regarding whether erythropoietin therapy is temporarily halted, maintained unchanged or intensified. Recently, the potential of erythropoietin therapy to increase red cell production in critically ill patients per se has received considerable attention. Experience in this field has interesting implications for the management of chronic anaemia in other clinical settings.