High dose Erythropoietin increases Brain Tissue Oxygen Tension in Severe Vasospasm after Subarachnoid Hemorrhage

Seven consecutive poor grade SAH patients with multimodal neuromonitoring (MM) received systemic EPO therapy (30.000？IU per day for 3 consecutive days) for severe cerebral vasospasm. Cerebral perfusion pressure (CPP), mean arterial blood pressure (MAP), intracranial pressure (ICP), PbtO2 and brain metabolic changes were analyzed during the next 24 hours after each dose given. Statistical analysis was performed with a mixed effects model.A total of 22 interventions were analyzed. Median age was 47？years (32–68) and 86？% were female. Three patients (38？%) developed DCI. MAP decreased 2 hours after intervention (P？<？0.04) without significantly affecting CPP and ICP. PbtO2 significantly increased over time (P？<？0.05) to a maximum of 7？±？4？mmHg increase 16 hours after infusion. Brain metabolic parameters did not change over time.EPO increases PbtO2 in poor grade SAH patients with severe cerebral vasospasm. The effect on outcome needs further investigation.