scholarly journals Six‐month outcomes after restrictive or liberal transfusion for cardiac surgery (TRICS III trial)

2019 ◽  
Vol 29 (2) ◽  
pp. 77-79 ◽  
Author(s):  
L. J. Estcourt ◽  
D. J. Roberts
Keyword(s):  
Cardiac Surgery ◽  
Liberal Transfusion

scholarly journals Restrictive Versus Liberal Transfusion Strategies for Cardiac Surgery

2019 ◽  
Vol 28 ◽  
pp. S339
Author(s):  
S. Conte ◽  
J. De Bono ◽  
D. Florisson ◽  
P. Vale
Keyword(s):  
Cardiac Surgery ◽  
Liberal Transfusion

scholarly journals Liberal transfusion strategy to prevent mortality and anaemia-associated, ischaemic events in elderly non-cardiac surgical patients – the study design of the LIBERAL-Trial

2018 ◽  
Author(s):  
Patrick Meybohm ◽  
Michael Bauer ◽  
Marion Ferner ◽  
Eva Wittenmeier ◽  
Karl-Heinz Gürtler ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Random Effect ◽  
Surgical Patients ◽  
Target Range ◽  
Transfusion Strategy ◽  
Compensatory Mechanisms ◽  
Geriatric Population ◽  
Acute Kidney Injury Stage ◽  
Liberal Transfusion

Abstract Background: Perioperative anaemia leads to impaired oxygen supply with a risk of vital organ ischaemia. In healthy and fit individuals, anaemia can be compensated by several mechanisms. Elderly patients, however, have less compensatory mechanisms because of multiple co-morbidities and aging-related decline of functional reserves. The purpose of the study is to evaluate whether elderly surgical patients may benefit from a liberal red blood cell (RBC) transfusion strategy compared to a restrictive transfusion strategy. Methods: The LIBERAL Trial is a prospective, randomized, multicentre, controlled clinical phase IV trial randomising 2,470 elderly (≥ 70 years) patients undergoing intermediate- or high-risk non-cardiac surgery. Registered patients will be randomised only if Haemoglobin (Hb) reaches ≤ 9 g/dl during surgery or within 3 days after surgery either to the LIBERAL group (transfusion of a single RBC unit when Hb ≤ 9 g/dl with a target range for the post-transfusion Hb level of 9-10.5 g/dl) or the RESTRICTIVE group (transfusion of a single RBC unit when Hb ≤ 7.5 g/dl with a target range for the post-transfusion Hb level of 7.5-9 g/dl). The intervention per patient will be followed until hospital discharge or up to 30 days after surgery, whichever occurs first. The primary efficacy outcome is defined as a composite of all-cause mortality, acute myocardial infarction, acute ischaemic stroke, acute kidney injury (stage III), acute mesenteric ischaemia and acute peripheral vascular ischaemia within 90 days after surgery. Infections requiring iv antibiotics with re-hospitalisation are assessed as important secondary endpoint. The primary endpoint will be analysed by logistic regression adjusting for age, cancer surgery (y/n), type of surgery (intermediate- or high-risk), and incorporating centres as random effect. Discussion: The LIBERAL-Trial will evaluate whether a liberal transfusion strategy reduces the occurrence of major adverse events after non-cardiac surgery in the geriatric population compared to a restrictive strategy within 90 days after surgery. Trial registration: ClinicalTrials.gov (identifier: NCT03369210)

scholarly journals Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery

2018 ◽  
Vol 379 (13) ◽  
pp. 1224-1233 ◽  
Author(s):  
C. David Mazer ◽  
Richard P. Whitlock ◽  
Dean A. Fergusson ◽  
Emilie Belley-Cote ◽  
Katherine Connolly ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Liberal Transfusion
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