Acute bleeding in patietns who refuse transfusion is a difficult clinical challenge. There is some avidence that recovery is enchanced by adminsitering erytropoietin but it is preliminary, recent and inconclusive. One study of post-ulcer bleeding anemia concluded that Erythropoietin administration significantly accelerates correction of anemia after acute ulcer bleeding. The haematocrit gain is equivalent to one unit of transfused blood two weeks after the bleeding episode. In this small retrospective study bleeding ceased and was not continuing at the time of erythropoeitin adminstration. Erythropoietin is often used in acutely bleeding patients who refuse transfusion but this strategy is not supported by credible literature and is of doubtful benefit.
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