Oxygen Extraction-guided Transfusion in Critically Ill Patients

Università degli Studi di Ferrara177 enrolled

Overview

Anemia is common in intensive care unit (ICU) patients and often appears early in the ICU course. The optimal management red blood cells RBC transfusion in critically ill patients remains controversial and clinical studies in this field have usually been based on transfusion thresholds. In the "TRICC" Trial, patients assigned to a restrictive transfusion strategy (transfusion if Hb\<7 g/dL) had similar mortality to patients transfused if Hb\<10 g/dL. Notably, none of the large RCT tried to focus on a personalize RBC transfusion protocol, i.e. a transfusion protocol which address the individual need for transfusion basing on physiological approach. We therefore hypothesized that patients with high extraction of oxygen could benefit more of RBCs transfusion regardless their hemoglobin levels.

Study Type

OBSERVATIONAL

Enrollment

177

Conditions

Anemia Critical Illness

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Hemoglobin level \<10 g/dL during the first 72 hours of ICU Exclusion Criteria: * Acute bleeding * Hemoglobin level less than 7 g/dL

Locations (1)

Università di Ferrara

Ferrara, Italy

Outcomes

Primary Outcomes

90-day mortality

mortality

Time frame: after 90 days from study enrollment

Secondary Outcomes

Acute kidney injury

Occurence of acute kidney injury according to KDIGO 2012 guidelines

Time frame: 7 days after study inclusion

Length of ICU stay

Time frame: from ICU admission to discharge, up to 8 weeks

Variation in Sequential Organ Failure Assessment (SOFA) score

daily variation in SOFA score (0-24 points scale with higher values indicating worst conditions)

Time frame: 5 days

Days of vasopressor

Need for vasopressor

Time frame: 28 days after study inclusion