MedPath

Transfusion Requirements in Cardiac Surgery

Not Applicable
Completed
Conditions
Cardiac Surgery
Registration Number
NCT01484639
Lead Sponsor
Nadine Shehata
Brief Summary

This is a multi-centre randomized controlled pilot trial of two transfusion strategies in high risk patients having cardiac surgery. This study will be conducted in 7 Canadian centers and 1 American centre. Patients allocated to a "restrictive" transfusion strategy will receive a red cell transfusion if their hemoglobin is 75 g/L or less intraoperatively and postoperatively. Patients allocated to a "liberal" transfusion strategy will receive red cell transfusion if their hemoglobin concentration is 95 g/L or less intraoperatively and postoperatively in the intensive care unit, and less than 85 g/L on the ward.

The primary objectives of this study are to determine 1) enrollment rates (patients enrolled/patients eligible), 2) consent rates (consent obtained/patients approached); and 3) protocol adherence (incidence and reasons for non adherence, lack of consent, rates of contamination and utilization of co-interventions). The secondary objectives are to determine 1) the mortality rate and the rate of the composite outcome for morbidity of renal, cardiac, neurological and infectious adverse events; 2) the proportion of missing data as a measure of the feasibility of the case report form; and 3) the proportion of blood products utilized (red cells, platelets and plasma).

The results of the multicentre pilot study will be used to 1) maximize enrollment rates to ensure timely completion of recruitment of a definitive large randomized controlled trial, 2) maximize adherence rates, 3) determine event rates for sample size estimation for a definitive study, and to 4) optimize the case report form.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
208
Inclusion Criteria
  • 18 years or older
  • European System for Cardiac Operative Risk Evaluation (EuroSCORE) of 6 or more
  • Consent
Exclusion Criteria
  • Pregnancy
  • Refusal of blood products
  • Participating in autologous blood donation program
  • Based on the preoperative hemoglobin, the predicted hematocrit on cardiopulmonary bypass is greater than 33% (hemoglobin concentration of 110 g/L) or less than 18% (hemoglobin concentration of 60 g/L)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Enrollment ratebaseline

To determine enrollment rates (patients enrolled/patients eligible), consent rates (consent obtained/patients approached)

Protocol adherence28 days or hospital discharge

To determine protocol adherence (incidence and reasons for non adherence, lack of consent, rates of contamination and utilization of co-interventions).

Secondary Outcome Measures
NameTimeMethod
Blood product utilization28 days or hospital discharge

To determine the proportion of blood products utilized (red cells, platelets and plasma)

Mortality and morbidity28 days or hospital discharge

To determine the mortality rate and a composite outcome for morbidity (renal, cardiac, neurological and infectious adverse events).

Missing data28 days or hospital discharge

To determine the proportion of missing data as a measure of the feasibility of the case report form

Trial Locations

Locations (8)

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

Foothills Medical Centre

🇨🇦

Calgary, Alberta, Canada

Alberta Health Services

🇨🇦

Edmonton, Alberta, Canada

St. Boniface General Hospital

🇨🇦

Winnipeg, Manitoba, Canada

Hamilton General Hospital

🇨🇦

Hamilton, Ontario, Canada

Ottawa Heart Institute

🇨🇦

Ottawa, Ontario, Canada

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

St Michael's Hospital

🇨🇦

Toronto, Ontario, Canada

Virginia Commonwealth University
🇺🇸Richmond, Virginia, United States

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