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To the Editor: I have several concerns about the study by Dr Corwin and colleagues.¹ First, the study includes a relatively select sample of patients. Many patients were posttraumatic, and management of their anemia may be quite different from the management of other types of critically ill patients. For instance, the authors excluded patients with renal failure who were receiving dialysis.

Second, the authors state that the mean hemoglobin level was significantly higher at the study end for the rHuEPO group vs the placebo group, but it would be important to know exactly when most of this increase occurred. The pharmacokinetics of erythropoietin are such that reticulocytosis occurs at 2 weeks, but the peak increase in hemoglobin may not occur for 2 months.^2-3 It is noteworthy, however, that the incidence of transfusions rose rapidly early in the study and then plateaued about 14 days after the study began. This time . . . [Full Text of this Article]

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