Restrictive and Liberal Transfusion Strategies in Intensive Care

Launched by UNIVERSITY OF EDINBURGH · Jul 21, 2009

Keywords

ClinConnect Summary

Anaemia is a common complication of critical illness and 40-50% of all patients in intensive care units (ICUs) receive blood transfusions. However, despite the perceived benefits of correcting anaemia, numerous non-randomised cohort studies and a system review suggest associations between blood transfusions and adverse patient outcomes. The only large randomised controlled trial comparing restrictive with liberal transfusion policies in critically ill patients (the "TRICC study") suggested a trend to greater morality at 30 days in the liberal transfusion group. However the TRICC study does ...

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Eligibility criteria

• Inclusion Criteria:
• • The patient remains in the ICU after 96 hours (4 days) or more following ICU admission
• • The patient has required mechanical ventilation via an endotracheal tube or tracheostomy tube for 96 hours or more
• • The patient is expected to require ≥24 hours of further mechanical ventilation at the time of assessment
• • The patient is aged ≥55 years of age
• • The patient has a Hb value of 90g/L or less at the time of assessment
• Exclusion Criteria:
• • Patient with active bleeding at the time of screening
• • Patient with traumatic brain injury as presenting diagnosis
• • Patient with intracranial haemorrhage as presenting diagnosis
• • Patient not expected to survive the next 48 hours at the time of assessment.
• • Patient objects to RBC transfusion
• • Patient receiving concurrent treatment with erythropoietin or similar erythropoietic agent
• • Follow up is not feasible
• • Already enrolled in another RCT with similar clinical endpoints