TY - JOUR
T1 - Pre-clinical study protocol
T2 - Blood transfusion in endotoxaemic shock
AU - Obonyo, Nchafatso G.
AU - Byrne, Liam
AU - Tung, John Paul
AU - Simonova, Gabriela
AU - Diab, Sara D.
AU - Dunster, Kimble R.
AU - Passmore, Margaret R.
AU - Boon, Ai Ching
AU - See Hoe, Louise
AU - Engkilde-Pedersen, Sanne
AU - Esguerra-Lallen, Arlanna
AU - Fauzi, Mohd H.
AU - Pimenta, Leticia P.
AU - Millar, Jonathan E.
AU - Fanning, Jonathon P.
AU - Van Haren, Frank
AU - Anstey, Chris M.
AU - Cullen, Louise
AU - Suen, Jacky
AU - Shekar, Kiran
AU - Maitland, Kathryn
AU - Fraser, John F.
N1 - Funding Information:
National Health and Medical Research Council, NHMRC, Australia (Grant ID APP1061382 ), Emergency Medicine Foundation, EMF, Australia (Grant ID EMPJ-358R25-2016 ), Australian Red Cross Blood Service .
Publisher Copyright:
© 2019 The Author(s)
PY - 2019
Y1 - 2019
N2 - The Surviving Sepsis Campaign (SCC) and the American College of Critical Care Medicine (ACCM) guidelines recommend blood transfusion in sepsis when the haemoglobin concentration drops below 7.0 g/dL and 10.0 g/dL respectively, while the World Health Organisation (WHO) guideline recommends transfusion in septic shock ‘if intravenous (IV) fluids do not maintain adequate circulation’, as a supportive measure of last resort. Volume expansion using crystalloid and colloid fluid boluses for haemodynamic resuscitation in severe illness/sepsis, has been associated with adverse outcomes in recent literature. However, the volume expansion effect(s) following blood transfusion for haemodynamic circulatory support, in severe illness remain unclear with most previous studies having focused on evaluating effects of either different RBC storage durations (short versus long duration) or haemoglobin thresholds (low versus high threshold) pre-transfusion. • We describe the protocol for a pre-clinical randomised controlled trial designed to examine haemodynamic effect(s) of early volume expansion using packed RBCs (PRBCs) transfusion (before any crystalloids or colloids) in a validated ovine-model of hyperdynamic endotoxaemic shock. • Additional exploration of mechanisms underlying any physiological, haemodynamic, haematological, immunologic and tissue specific-effects of blood transfusion will be undertaken including comparison of effects of short (≤5 days) versus long (≥30 days) storage duration of PRBCs prior to transfusion.
AB - The Surviving Sepsis Campaign (SCC) and the American College of Critical Care Medicine (ACCM) guidelines recommend blood transfusion in sepsis when the haemoglobin concentration drops below 7.0 g/dL and 10.0 g/dL respectively, while the World Health Organisation (WHO) guideline recommends transfusion in septic shock ‘if intravenous (IV) fluids do not maintain adequate circulation’, as a supportive measure of last resort. Volume expansion using crystalloid and colloid fluid boluses for haemodynamic resuscitation in severe illness/sepsis, has been associated with adverse outcomes in recent literature. However, the volume expansion effect(s) following blood transfusion for haemodynamic circulatory support, in severe illness remain unclear with most previous studies having focused on evaluating effects of either different RBC storage durations (short versus long duration) or haemoglobin thresholds (low versus high threshold) pre-transfusion. • We describe the protocol for a pre-clinical randomised controlled trial designed to examine haemodynamic effect(s) of early volume expansion using packed RBCs (PRBCs) transfusion (before any crystalloids or colloids) in a validated ovine-model of hyperdynamic endotoxaemic shock. • Additional exploration of mechanisms underlying any physiological, haemodynamic, haematological, immunologic and tissue specific-effects of blood transfusion will be undertaken including comparison of effects of short (≤5 days) versus long (≥30 days) storage duration of PRBCs prior to transfusion.
KW - Blood transfusion
KW - Endotoxaemic shock
KW - Guidelines
KW - Haemoglobin threshold
KW - Packed red blood cells (PRBCs)
KW - RESUS transfusion protocol
KW - Sepsis
KW - Storage duration
UR - http://www.scopus.com/inward/record.url?scp=85065774094&partnerID=8YFLogxK
U2 - 10.1016/j.mex.2019.05.005
DO - 10.1016/j.mex.2019.05.005
M3 - Article
AN - SCOPUS:85065774094
SN - 2215-0161
VL - 6
SP - 1124
EP - 1132
JO - MethodsX
JF - MethodsX
ER -