Article Data

  • Views 1073
  • Dowloads 146

Original Research

Open Access

Efficacy observation of erythropoietin on sepsis complicated with acute respiratory distress syndrome

  • Ling Jia1,†
  • Xiang Xue1,†
  • Weixiao Zhang2
  • Jianqin Cai1
  • Jinghui Yang1,*,
  • Wei Zhao1,*,

1Department of Critical Care Medicine, SIR RUN RUN hospital of Nanjing Medical University, 211100 Nanjing, Jiangsu, China

2Department of Radiology, SIR RUN RUN hospital of Nanjing Medical University, 211100 Nanjing, Jiangsu, China

DOI: 10.22514/sv.2024.046 Vol.20,Issue 4,April 2024 pp.99-105

Submitted: 10 January 2024 Accepted: 18 March 2024

Published: 08 April 2024

*Corresponding Author(s): Jinghui Yang E-mail:
*Corresponding Author(s): Wei Zhao E-mail:

† These authors contributed equally.


This study is to evaluate the efficacy of erythropoietin in treating sepsis-associated acute respiratory distress syndrome (ARDS). One hundred patients with sepsis-related ARDS were randomized into the placebo group and Erythropoietin (EPO) group. Patients in the placebo group received saline as placebo on the standard therapy, while the EPO group received recombinant human erythropoietin injections on the standard therapy. It was found that the heart rate and mean arterial pressure did not differ significantly between days 7 and 14 after treatment initiation (p > 0.05). The partial pressure of oxygen (PaO2) and oxygenation index levels measured on days 7 and 14 were significantly higher than the placebo group and partial pressure of carbon dioxide (PaCO2) was significantly lower than the placebo group (p < 0.05). Lung capacity and functional residual capacity (and FRC) increased significantly in tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and C-reactive protein (CRP) concentrations (p < 0.05). In the EPO group, the duration of mechanical ventilation was significantly shorter and the mortality rate was significantly reduced (Log-Rank test, χ2 = 4.651, p = 0.031). The results confirm that EPO significantly improves lung function and blood gas parameters, reduces serum levels of inflammatory markers, and reduces the risk of death in sepsis-induced ARDS patients, highlighting the potential therapeutic role of EPO in the management of this disease.


Erythropoietin; Sepsis; Acute respiratory distress syndrome; Efficacy

Cite and Share

Ling Jia,Xiang Xue,Weixiao Zhang,Jianqin Cai,Jinghui Yang,Wei Zhao. Efficacy observation of erythropoietin on sepsis complicated with acute respiratory distress syndrome. Signa Vitae. 2024. 20(4);99-105.


[1] Bos LDJ, Ware LB. Acute respiratory distress syndrome: causes, pathophysiology, and phenotypes. The Lancet. 2022; 400: 1145–1156.

[2] Fang Q, Wang Q, Zhou Z, Xie A. Consensus analysis via weighted gene co-expression network analysis (WGCNA) reveals genes participating in early phase of acute respiratory distress syndrome (ARDS) induced by sepsis. Bioengineered. 2021; 12: 1161–1172.

[3] Gorman EA, O’Kane CM, McAuley DF. Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management. The Lancet. 2022; 400: 1157–1170.

[4] Coleman MH, Aldrich JM. Acute respiratory distress syndrome: ventilator management and rescue therapies. Critical Care Clinics. 2021; 37: 851–866.

[5] Wu YW, Comstock BA, Gonzalez FF, Mayock DE, Goodman AM, Maitre NL, et al. Trial of erythropoietin for hypoxic-ischemic encephalopathy in newborns. The New England Journal of Medicine. 2022; 387: 148–159.

[6] Tsiftsoglou AS. Erythropoietin (EPO) as a key regulator of erythropoiesis, bone remodeling and endothelial transdifferentiation of multipotent mesenchymal stem cells (MSCs): implications in regenerative medicine. Cells. 2021; 10: 2140.

[7] Hanna RM, Streja E, Kalantar-Zadeh K. Burden of anemia in chronic kidney disease: beyond erythropoietin. Advances in Therapy. 2021; 38: 52–75.

[8] Fishbane S, Pollock CA, El-Shahawy M, Escudero ET, Rastogi A, Van BP, et al. Roxadustat versus epoetin alfa for treating anemia in patients with chronic kidney disease on dialysis: results from the randomized phase 3 ROCKIES study. Journal of the American Society of Nephrology. 2022; 33: 850–866.

[9] Sergio C, Rolando C. Erythropoietin regulates signaling pathways associated with neuroprotective events. Experimental Brain Research. 2022; 240: 1303–1315.

[10] Sanyaolu A, Patidar R, Ayodele O, Marinkovic A, Desai P. Pediatric sepsis: the importance of understanding criteria for diagnosis. Pediatric Annals. 2022; 51: e405–e408.

[11] Gragossian A, Siuba MT. Acute respiratory distress syndrome. Emergency Medicine Clinics of North America. 2022; 40: 459–472.

[12] Bitker L, Talmor D, Richard J. Imaging the acute respiratory distress syndrome: past, present and future. Intensive Care Medicine. 2022; 48: 995–1008.

[13] Zheng F, Pan Y, Yang Y, Zeng C, Fang X, Shu Q, et al. Novel biomarkers for acute respiratory distress syndrome: genetics, epigenetics and transcriptomics. Biomarkers in Medicine. 2022; 16: 217–231.

[14] Yehya N, Smith L, Thomas NJ, Steffen KM, Zimmerman J, Lee JH, et al. Definition, incidence, and epidemiology of pediatric acute respiratory distress syndrome: from the second pediatric acute lung injury consensus conference. Pediatric Critical Care Medicine. 2023; 24: S87–S98.

[15] Sinha P, Meyer NJ, Calfee CS. Biological phenotyping in sepsis and acute respiratory distress syndrome. Annual Review of Medicine. 2023; 74: 457–471.

[16] Fan Y, Ye Z, Tang Y. Serum HMGB1 and soluble urokinase plasminogen activator receptor levels aid diagnosis and prognosis prediction of sepsis with acute respiratory distress syndrome. Biomarkers in Medicine. 2023; 17: 231–239.

[17] Vittori DC, Chamorro ME, Hernández YV, Maltaneri RE, Nesse AB. Erythropoietin and derivatives: potential beneficial effects on the brain. Journal of Neurochemistry. 2021; 158: 1032–1057.

[18] Wang Y, Song J, Sun H, Xu F, Li K, Nie C, et al. Erythropoietin prevents necrotizing enterocolitis in very preterm infants: a randomized controlled trial. Journal of Translational Medicine. 2020; 18: 308.

[19] Zhang S, Luo Y, Wang R. The effects of erythropoietin on neurogenesis after ischemic stroke. Journal of Integrative Neuroscience. 2020; 19: 561–570.

[20] Gu J, Ran X, Deng J, Zhang A, Peng G, Du J, et al. Glycyrrhizin alleviates sepsis-induced acute respiratory distress syndrome via suppressing of HMGB1/TLR9 pathways and neutrophils extracellular traps formation. International Immunopharmacology. 2022; 108: 108730.

[21] Wu X, Zhu Y, Qi Y, Xu W, Jing-Zhai. Erythropoietin, as a biological macromolecule in modification of tissue engineered constructs: a review. International Journal of Biological Macromolecules. 2021; 193: 2332–2342.

[22] Zhang W, Lin H, Zou M, Yuan Q, Huang Z, Pan X, et al. Nicotine in inflammatory diseases: anti-inflammatory and pro-inflammatory effects. Frontiers in Immunology. 2022; 13: 826889.

[23] Kim C, Sim H, Bae JS. Benzoylpaeoniflorin activates anti-inflammatory mechanisms to mitigate sepsis in cell-culture and mouse sepsis models. International Journal of Molecular Sciences. 2022; 23: 13130.

[24] Oorschot DE, Sizemore RJ, Amer AR. Treatment of neonatal hypoxic-ischemic encephalopathy with erythropoietin alone, and erythropoietin combined with hypothermia: history, current status, and future research. International Journal of Molecular Sciences. 2020; 21: 1487.

[25] Hemani S, Lane O, Agarwal S, Yu SP, Woodbury A. Systematic Review of Erythropoietin (EPO) for neuroprotection in human studies. Neurochemical Research. 2021; 46: 732–739.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time