Erythropoietin mimics the acute phase response in critical illness

Background: In a prospective observational study, we examined the temporal relationships between serum erythropoietin (EPO) levels, haemoglobin concentration and the inflammatory response in critically ill patients with and without acute renal failure (ARF). Patients and method Twenty-five critically ill patients, from general and cardiac intensive care units (ICUs) in a university hospital, were studied. Eight had ARF and 17 had normal or mildly impaired renal function. The comparator group included 82 nonhospitalized patients with normal renal function and varying haemoglobin concentrations. In the patients, levels of haemoglobin, serum EPO, C-reactive protein, IL-1β, IL-6, serum iron, ferritin, vitamin B12 and folate were measured, and Coombs test was performed from ICU admission until discharge or death. Concurrent EPO and haemoglobin levels were measured in the comparator group. Results: EPO levels were initially high in patients with ARF, falling to normal or low levels by day 3. Thereafter, almost all ICU patients demonstrated normal or low EPO levels despite progressive anaemia. IL-6 exhibited a similar initial pattern, but levels remained elevated during the chronic phase of critical illness. IL-1β was undetectable. Critically ill patients could not be distinguished from nonhospitalized anaemic patients on the basis of EPO levels. Conclusion: EPO levels are markedly elevated in the initial phase of critical illness with ARF. In the chronic phase of critical illness, EPO levels are the same for patients with and those without ARF, and cannot be distinguished from noncritically ill patients with varying haemoglobin concentrations. Exogenous EPO therapy is unlikely to be effective in the first few days of critical illness.

A concise summary of the International System of Units, the SI

The Bureau International des Poids et Mesures, the BIPM, was established by Article 1 of the Convention du Mètre, on 20 May 1875, and is charged with providing the basis for a single, coherent system of measurements to be used throughout the world. The decimal metric system, dating from the time of the French Revolution, was based on the metre and the kilogram. Under the terms of the 1875 Convention, new international prototypes of the metre and kilogram were made and formally adopted by the first Conférence Générale des Poids et Mesures (CGPM) in 1889. Over time this system developed, so that it now includes seven base units. In 1960 it was decided at the 11th CGPM that it should be called the Système International d’Unités, the SI (in English: the International System of Units). The SI is not static but evolves to match the world’s increasingly demanding requirements for measurements at all levels of precision and in all areas of science, technology, and human endeavour. This document is a summary of the SI Brochure, a publication of the BIPM which is a statement of the current status of the SI. The seven base units of the SI, listed in Table 1, provide the reference used to define all the measurement units of the International System. As science advances, and methods of measurement are refined, their definitions have to be revised. The more accurate the measurements, the greater the care required in the realization of the units of measurement.