A Pilot Study on the Impact of Rejuvenated Autologous Blood Transfusion on VO2 Max in Healthy Subjects
试验速览
- 阶段
- 4 期
- 状态
- 终止
- 入组人数
- 9
- 试验地点
- 2
- 主要终点
- Change in VO2max
研究概览
简要总结
To compare the physiologic benefits of rejuvenated RBCs (rejRBCs) to standards RBCs (PRBCs), we will emulate critical conditions by safely maximizing stress on the cardiovascular system, in an elective, feasible volunteer study. Maximal oxygen uptake (VO2max) will be measured in an anemic, post-donation, pre-transfusion state, and also after transfusing 14-day-old, autologous blood randomized to standard storage or standard storage with rejuvenation. We hypothesize that transfusion of standard PRBCs is less effective at increasing oxygen delivery (measured by VO2max) compared with transfusion of rejRBCs.
详细描述
VISIT A ( - Screening) Written informed consent will be obtained from subjects who respond to an IRB-approved advertisement/flyer and fulfill eligibility requirements. The following video will help explain the study: vimeo.com/167291799. Individuals who respond to an IRB approved advertisement/flyer (uploaded to eIRB) will be given information about the study and asked to read an IRB approved consent form. An investigator or designee will obtain written informed consent from each individual participating in this study, after adequate explanation of the methods, objectives, and potential hazards of the study. The investigator or designee will also explain to the subjects that they are completely free to refuse to enter the study and free to withdraw from it at any time. A copy of the signed consent form will be given to the subject and will be shared with The Blood Connection to ensure proper labeling of autologous units.
After subjects have provided written informed consent, they will be asked to answer several questions in 2 written questionnaires (uploaded to eIRB) in order to confirm that they are eligible to donate blood. These questions are similar to those routinely asked to people prior to a blood donation. These are focused upon keeping the risks of blood donation to the lowest possible level. Subject will undergo screening lab tests for baseline hemoglobin, sickle cell trait, serum pregnancy tests only for women of child-bearing potential, ECG, exercise test. Subject will receive a phone confirmation from the investigator or delegated research staff after review of the screening lab results. Subject will bring a copy of the signed consent form to The Blood Connection if qualified.
VISIT B (Day 0 - Blood donation) The Blood Connection (TBC), Raleigh, NC, is registered and licensed by the US FDA and accredited by the American Association of Blood Banks (AABB) to manufacture RBCs and other blood products. Two units of blood will be withdrawn from each subject according to standards for double, AS-3, apheresis units, and will be marked for autologous donation, and purchased by Duke Transfusion Services, as arranged with the medical director of TBC (Robert Rainer, MD). RBC handling and storage will meet FDA and AABB standards; units will be stored with Duke Transfusion Services c/o Dr. Poisson.
VISIT C (Day 14 - "Anemic" VO2 max, Transfusion (Tx) and "post-Tx" VO2max)) Small amount of blood [3 lavender topped tubes] will be collected from subject to test for hemoglobin, type & screen and 1 cross match to verify the donated blood received from The Blood Connection belongs to the same subject who arrives at the appointed date at Duke facility
Anemic VO2max Three minutes of resting baseline measures will be recorded before the start of exercise. The subject will then begin to pedal the cycle ergometer at a cadence of 75 rpm. Resistance will be manually set according to a standardized, progressive protocol. A rating of perceived exertion (RPE) will be obtained at the end of each exercise stage. Vital signs will be recorded every 3 minutes, and ECG monitoring will be continuous. Exercise will be terminated when the subject reaches volitional fatigue. VO2max will be reported as the highest oxygen consumption averaged over two 30-second periods, which typically occurs in the last stage of the progressive maximal exercise test. Maximum heart rate will be the heart rate at or near VO2max. To minimize variability in VO2max testing procedures, the same 2 facilitators (an engineer/technician and a research staff) will be present at every test. Radial arterial access will be obtained for cardiac output monitoring (LiDCO pulse contour analysis) at this visit.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Basic Science
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
盲法说明
Addition of rejuvesol will be performed by the blood bank and only they will know of group assignment
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Healthy male or female
- •Age 18-40 (the American College of Sports Medicine Guidelines for Exercise Testing defines this age group with no or no more than one coronary heart disease risk factor as low-risk for VO2 max testing)
- •Habitual exerciser defined as ≥ 30 minutes of at least moderate or high intensity exercise ≥ 3 times per week. After consent, and at the subsequent screening visit, a VO2 max test will be performed, and subjects with a low value (< 35 mL/kg/min) will be excluded (screen failure). Based on our previous experience, we anticipate that up to 25% of the subjects will fall into this category; therefore, 10 subjects will be screened to obtain 6-8 participants who go on to donate their blood.
- •Calculated total blood volume of at least 4,500 mL using an established formula:
- •Men: (0.006012 x H3) + (14.6 x W) + 604 = TBV
- •Women: (0.005835 x H3) + (15 x W) + 183 = TBV [H= Height in inches; W=Weight in pounds]
- •Has access to transportation to visit the blood collection facility and to return to Duke for all study visits
- •Weighs at least 130 pounds
排除标准
- •Any significant acute or chronic medical illness or problem, including, but not limited to, diabetes, hypertension, cardiac disease, asthma, COPD
- •Current or recent (last 60 days) tobacco or nicotine use
- •History of sickle cell trait or disease or any other acquired or hereditary hematological abnormality
- •History of fainting or other significant adverse reaction during phlebotomy or donation of blood
- •Known prolonged QTc (or evidence of such at screening) defined as QTc >470 ms
- •Known or suspected illicit drug or alcohol abuse
- •Known or suspected HIV, Hepatitis B, or Hepatitis C infection
- •History of thrombophilia or anticoagulant therapy
- •Pregnancy
- •Obesity defined as BMI>30
- •Recent history of blood donation:
- •Single whole blood unit donation within the past 8 weeks
- •Double RBC donation by apheresis within the past 16 weeks
- •Plasma donation by apheresis within the past 4 weeks
- •Inadequate red blood cell mass evidenced by total blood volume <4500 mL (above) or screening hemoglobin <13.3 g/dL
- •Known hypersensitivity to lithium compounds.
结局指标
主要结局
Change in VO2max
时间窗: Day 16 to Day 18 post transfusion
Change in VO2max from "anemic" (pre-transfusion) VO2max and after transfusion of 2 units of either standard PRBCs or rej-PRBCs "post-Tx" VO2max.
Change in Lactate
时间窗: Day 16 to Day 18 post transfusion
Change in lactate from "anemic" (pre-transfusion) VO2max and after transfusion of 2 units of either standard PRBCs or rej-PRBCs "post-Tx" VO2max
次要结局
- Change in "Post-Tx" VO2max From Baseline(Baseline to Day 18 post transfusion)