The purpose of this study is whether the mitochondrial oxygenation tension (mitoPO2) is a feasible and reliable tool in ICU patients with anaemia undergoing red cell transfusion to ultimately personalize blood transfusion decisions in the ICU.
Evidence is increasing that in some cases a Hb trigger of 7-8g/dl may be too low and te question arises whether an individualized red cell transfusion strategy may benefit critically ill patients. New studies have shown the potential of protoporphyrin IX-triple state lifetime technique to measure mitochondrial oxygenation tension (mitoPO2) in vivo, which possibly is an early indicator of oxygen disturbance in the cell and therefore a physiological trigger for red cell transfusion. The goals are: 1. Determining the feasibility of using mitoPO2 and the variability of mitoPO2 measurements in critically ill intensive care unit (ICU) patients before and after receiving a red cell transfusion 2. Describing the effects of red cell transfusion and the associated change in \[Hb\] on mitoPO2 and on other physiologic measures of tissue oxygenation and oxygen balance 3. Describing the association between mitoPO2 and vital organ functions. Included patients will undergo red cell transfusion as planned. However, red cell transfusion will be delayed by 2 hours. At multiple predefined moments data collection including blood samples and measurements of mitoPO2 will take place. The results of this study cannot be immediately translated to clinical practice. Using these results, the investigators will design a phase 2 diagnostic study, most probably a randomized clinical trial that will yield applied knowledge with respect to personalizing red cell transfusion. Application will be in ICU patients with anaemia who might or might not profit from red cell transfusions. It will lead to a reduction of both over- and under- transfusion.
Study Type
OBSERVATIONAL
Enrollment
103
Amsterdam Medical Center
Amsterdam, Amsterdam-Zuidoost, Noord-Holland, Netherlands
Leiden University Medical Center
Leiden, South Holland, Netherlands
Variability of mitoPO2
Variability of mitoPO2 before and after red cell transfusion. This will be compared to traditional parameters used to measure oxygenation and oxygen balance.
Time frame: Variability of mitoPO2 will be assessed during 8 predefined moments (within a timeframe of 24 hours) in the study
Organ damage
Value of mitoPO2 measurements for predicting (ischemic) organ damage
Time frame: Value of mitoPO2 in predicting (ischemic) organ damage will be assessed during 8 predefined moments (within a timeframe of 24 hours) in the study
Microcirculation
Association of mitoPO2 with the microcirculation
Time frame: Association of the mitoPO2 with the microcirculation will be assessed during 2 predefined moments (before transfusion and 24 hours after transfusion) in the study
Length of stay
Length of hospital-stay and ICu stay
Time frame: Length of stay will be assessed during the 3 months follow-up time
Mortality
90-day mortality, hospital mortality and ICU mortality
Time frame: Mortality will be assessed during the 3 months follow-up time
Adverse events
Adverse and serious adverse events of the mitoPO2 measurements
Time frame: Association of the mitoPO2 with adverse events will be assessed during 8 predefined moments (within a timeframe of 24 hours) in the study
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