A multi-centre randomised controlled trial of Transfusion Indication Threshold Reduction on transfusion rates, morbidity and healthcare resource use following cardiac surgery: study protocol

Transfus Apher Sci. 2014 Jun;50(3):451-61. doi: 10.1016/j.transci.2014.02.020. Epub 2014 Mar 12.

Abstract

Thresholds for red blood cell transfusion following cardiac surgery vary by hospital and surgeon. The TITRe2 multi-centre randomised controlled trial aims to randomise 2000 patients from 17 United Kingdom centres, and tests the hypothesis that a restrictive transfusion threshold will reduce postoperative morbidity and health service costs compared to a liberal threshold. Patients consent to take part in the study pre-operatively but are only randomised if their haemoglobin falls below 9 g/dL during their post-operative hospital stay. The primary outcome is a binary composite outcome of any serious infectious or ischaemic event in the first three months after randomisation. Many challenges have been encountered in the set-up and running of the study.

Keywords: Cardiac surgery; Protocol; Red cell; Restrictive; Transfusion.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Transfusion*
  • Cardiac Surgical Procedures
  • Female
  • Follow-Up Studies
  • Hemoglobins / metabolism
  • Humans
  • Male
  • Postoperative Complications* / blood
  • Postoperative Complications* / mortality
  • Postoperative Complications* / therapy
  • Retrospective Studies
  • Time Factors
  • United Kingdom

Substances

  • Hemoglobins