Anemia Clinical Trial
Official title:
Encuesta Sobre prácticas de transfusión de glóbulos Rojos en el Paciente crítico Atendido en Unidades de Altura
The purpose of this study is to describe current practice on red blood cell transfusion in critically ill patients of intensive care units located in high altitude areas
Anemia has been identified as a common complication in the critically ill patient.
Approximately 40 and 60% are transfused in normal clinical practice. However transfusions
are not free of adverse events including: transfusion-associated lung injury, infectious
complications, progression of organ failure, fluid overload associated with transfusion,
among others. Therefore, several clinical trials have been designed to define red blood cell
transfusion thresholds. Mainly two groups have been compared: 1) liberal schemes in which
patients are transfused with higher levels of hemoglobin (generally ≤ 10 g / dL) and
restrictive regimens with lower levels (≤ 7 g / dL). Institutions such as the British
Committee for Standards in Hematology have developed recommendations in favor of restrictive
strategies based mainly on the TRICC (Transfusion Requirements In Critical Care) study
conducted by Hebert et al.
On the other hand, it is well known that as consequences of living in places at high
altitude physiological modifications occur in the human. One of these adaptations is the
increase in hemoglobin levels occurring in people living at high altitude, especially in
Andean residents, in whom the hypoxia promotes an increase in the production of red blood
cells.
The recommendation of the restrictive strategy in the transfusion of red blood cells has
been adopted in several countries with numerous populations living at high altitudes,
although this practice has not been evaluated in these patients.
The purpose of this study is to describe the current practice on transfusion of red blood
cells in critical patients treated in intensive care units located in high altitude areas
(over 1500 m) to determine whether physicians follow the recommendations of restrictive
strategies.
This is an observational, non-randomized, cross-sectional survey performed with intensivists
of Bolivia, Colombia, Ecuador, México and Perú. The data will be collected from an on-line
scenaries based survey. The survey is designated to assessed the effect of severity, need of
surgery, severe hypoxia, and alteration in tisular perfusion as modifiers of transfusion
thresholds. Besides unit characteristics as geographical altitude and type of unit will be
collected.
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