Age of Transfused Blood in Critically Ill Adults

Lacroix, Jacques; Hébert, Paul C.; Fergusson, Dean; Tinmouth, Alan; Cook, Deborah J.; Marshall, John C.; Clayton, Lucy; McIntyre, Lauralyn; Callum, Jeannie; Turgeon, Alexis F.; Blajchman, Morris A.; Walsh, Timothy; Stanworth, Simon; Campbell, Helen; Capellier, Gilles; Tiberghien, Pierre; Bardiaux, L.; Watering, Leo van de; Meer, Nardo J. van der; Sabri, Elham; Act, Abstr

doi:10.1056/nejmoa1500704

Cited by 498 publications

(457 citation statements)

References 35 publications

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“…This cohort was analysed, and the trial was published based on follow-up data for up to 90 days (the primary end point). 31 During recruitment, it was clear that the UK target sample of 500 patients would not be achieved by the time that the international trial completed recruitment. In order to acquire sufficient data to maximise the value of the economic evaluation, we sought agreement from the international ABLE TSC, the funder (the NIHR HTA programme) and ethics committees to continue recruitment in UK centres until the main database was locked for analysis.…”

Section: Uk Analysis In the Context Of The International Age Of Bloodmentioning

confidence: 99%

“…he results of the international ABLE trial, which included the majority of the UK cohort of patients, have been published previously. 31 We present here a summary of the UK cohort, with comparison with effects observed in the main trial cohort. The UK cohort was underpowered for the primary and secondary trial outcomes, as expected from the outset of the project, but comparison with the main trial is useful to understand any possible differences between the UK cohort and the international trial population.…”

Section: Follow-upmentioning

confidence: 99%

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The Age of BLood Evaluation (ABLE) randomised controlled trial: description of the UK-funded arm of the international trial, the UK cost–utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-care costs during the 12-month follow-up

Walsh

Stanworth

Boyd

et al. 2017

Health Technol Assess

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on behalf of the UK ABLE trial investigatorsThe Age of BLood Evaluation (ABLE) randomised controlled trial: description of the UK-funded arm of the international trial, the UK cost-utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-care costs during the 12-month follow-up The full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/144/51. The contractual start date was in September 2011. The draft report began editorial review in September 2016 and was accepted for publication in April 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the int...

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Section: Uk Analysis In the Context Of The International Age Of Bloodmentioning

confidence: 99%

Section: Follow-upmentioning

confidence: 99%

The Age of BLood Evaluation (ABLE) randomised controlled trial: description of the UK-funded arm of the international trial, the UK cost–utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-care costs during the 12-month follow-up

Walsh

Stanworth

Boyd

et al. 2017

Health Technol Assess

Self Cite

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“…10 Recently, several randomized controlled trials, in particular in clinical settings, have been completed, and no difference was observed between groups. [11][12][13] There remains considerable debate surrounding this issue; 14 however, this is unrelated to the goal of providing the best RBC units available, and to storing RBCs so as to generate the most efficacious product. The goal of the current study is to elucidate donor biology that affects RBC storage, and the ability of the RBC to circulate post transfusion.…”

Section: Introductionmentioning

confidence: 99%

Metabolic pathways that correlate with post-transfusion circulation of stored murine red blood cells

Wolski

Dumont³

et al. 2016

Haematologica

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T ransfusion of red blood cells is a very common inpatient procedure, with more than 1 in 70 people in the USA receiving a red blood cell transfusion annually. However, stored red blood cells are a non-uniform product, based upon donor-to-donor variation in red blood cell storage biology. While thousands of biological parameters change in red blood cells over storage, it has remained unclear which changes correlate with function of the red blood cells, as opposed to being co-incidental changes. In the current report, a murine model of red blood cell storage/transfusion is applied across 13 genetically distinct mouse strains and combined with high resolution metabolomics to identify metabolic changes that correlated with red blood cell circulation post storage. Oxidation in general, and peroxidation of lipids in particular, emerged as changes that correlated with extreme statistical significance, including generation of dicarboxylic acids and monohydroxy fatty acids. In addition, differences in anti-oxidant pathways known to regulate oxidative stress on lipid membranes were identified. Finally, metabolites were identified that differed at the time the blood was harvested, and predict how the red blood cells perform after storage, allowing the potential to screen donors at time of collection. Together, these findings map out a new landscape in understanding metabolic changes during red blood cell storage as they relate to red blood cell circulation. ABSTRACT

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“…Allogeneic blood transfusions carry inherent risk [5], and studies have increasingly linked transfusions with adverse clinical patient outcomes, including health care-associated infection [6], morbidity, and mortality [7][8][9], possibly related to storage lesions due to impairment of red blood cell (RBC) in the O 2 -dependent regulation of blood flow (hypoxic vasodilatation) [10]. Results of two recently published trials [11,12] found no differences in clinical patient outcomes for patients who received fresher (7-10 days) vs. older (more than 21 days) RBC; however, two additional trials are pending or in progress [13,14]. To curtail inappropriate and potentially injurious transfusions, accreditation agencies including AABB and The Joint Commission (TJC) have initiated in Patient Blood Management (PBM), programs to promote restrictive transfusion practices [15,16].…”

Section: Introductionmentioning

confidence: 99%

Is there a “magic” hemoglobin number? Clinical decision support promoting restrictive blood transfusion practices

Goodnough

Shah

2015

American J Hematol

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Blood transfusion has been identified as one of the most frequently performed therapeutic procedures, with a significant percentage of transfusions identified to be inappropriate. Recent key clinical trials in adults have provided Level 1 evidence to support restrictive red blood cell (RBC) transfusion practices. However, some advocates have attempted to identify a “correct” Hb threshold for RBC transfusion; whereas others assert that management of anemia, including transfusion decisions, must take into account clinical patient variables, rather than simply one diagnostic laboratory test. The heterogeneity of guidelines for blood transfusion by a number of medical societies reflects this controversy. Clinical decision support (CDS) uses a Hb threshold number in a smart Best Practices Alert (BPA) upon physician order, to trigger a concurrent utilization self‐review for whether blood transfusion therapy is appropriate. This review summarizes Level 1 evidence in seven key clinical trials in adults that support restrictive transfusion practices, along strategies made possible by CDS that have demonstrated value in improving blood utilization by promoting restrictive transfusion practices. Am. J. Hematol. 90:927–933, 2015. © 2015 Wiley Periodicals, Inc.

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Age of Transfused Blood in Critically Ill Adults

Abstract: Transfusion of fresh red cells, as compared with standard-issue red cells, did not decrease the 90-day mortality among critically ill adults. (Funded by the Canadian Institutes of Health Research and others; Current Controlled Trials number, ISRCTN44878718.).

Cited by 498 publications

References 35 publications

The Age of BLood Evaluation (ABLE) randomised controlled trial: description of the UK-funded arm of the international trial, the UK cost–utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-care costs during the 12-month follow-up

The Age of BLood Evaluation (ABLE) randomised controlled trial: description of the UK-funded arm of the international trial, the UK cost–utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-care costs during the 12-month follow-up

Metabolic pathways that correlate with post-transfusion circulation of stored murine red blood cells

Is there a “magic” hemoglobin number? Clinical decision support promoting restrictive blood transfusion practices

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