Restrictive Versus Liberal Thresholds for RBC Transfusion in ECMO

Launched by ACADEMISCH MEDISCH CENTRUM - UNIVERSITEIT VAN AMSTERDAM (AMC-UVA) · Aug 15, 2024

Keywords

ClinConnect Summary

This clinical trial is investigating two different approaches to giving red blood cell (RBC) transfusions to patients on a life-support machine called extracorporeal membrane oxygenation (ECMO). The researchers want to find out if using a "restrictive" strategy—where transfusions are given only when hemoglobin levels drop to 7.0 g/dL—is just as safe as a "liberal" strategy, where transfusions start at a higher hemoglobin level of 9.0 g/dL. The main goal is to see if either method affects the chances of survival within 90 days after the treatment.

To participate in this trial, individuals must be 18 years or older and currently receiving ECMO. They should not be expected to survive for more than 24 hours, cannot refuse blood transfusions for personal or religious reasons, and should not have been on ECMO for more than 48 hours before being screened for the study. Participants will receive one of the two transfusion strategies and will be monitored for various health outcomes, including survival, hospital stay length, and quality of life. This study is important because it may help set better guidelines for blood transfusions in critically ill patients, potentially improving their care while also addressing the cost and availability of blood products.

Gender

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Eligibility criteria

• Inclusion Criteria:
• • Patient is aged 18 years or older;
• • Is receiving ECMO;
• • (Deferred) informed consent.
• Exclusion Criteria:
• • Not expected to survive for 24 hours when assessed;
• • Inability to receive blood products;
• • (Known) decline to blood transfusions (e.g., Jehovah's Witnesses);
• • Extracorporeal carbon dioxide removal (ECCO2R) using low blood flow devices or pumpless devices (i.e., MINILUNG ®, PrismaLung+);
• • Received ECMO over 48h before screening for eligibility.