Point-of-Care RBC Washing to Prevent Transfusion-Related Pulmonary Complications
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
Minnesota
-
Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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-
North Carolina
-
Durham, North Carolina, United States, 27710
- Duke University Medical Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age equal to or greater than 18 years of age.
- Scheduled to have cardiac bypass surgery at Mayo Clinic in Rochester, Minnesota or Duke University Medical Center in Durham, North Carolina
- At risk for needing at least 4 units of blood during/after surgery
Exclusion Criteria:
- Emergency surgery
- Immunoglobulin A (IgA) deficiency
- History of severe recurrent transfusion reactions
- Refusal to receive allogeneic blood products
- Refusal to provide informed consent
- Prevalent lung injury prior to randomization
- Prevalent congestive heart failure prior to randomization
- Expected hospital stay < 48 hours
- Not anticipated to survive > 48 hours
- Previously enrolled in this trial
- No plan for placement of a pulmonary artery catheter
- Use of home oxygen therapy
- Complex RBC antibody profiles
- Need for the use of irradiated RBCs
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Standard of care red blood cell transfusion
Red blood cells that are administered in the normal fashion.
|
|
|
Experimental: Point-of-Care washed red blood cell transfusion
Red blood cells that are washed at the point-of-care.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Biomarkers Associated With Transfusion-Related Acute Lung Injury and Transfusion Associated Circulatory Overload.
Time Frame: 18 hours after the initiation of the first red blood cell transfusion.
|
This panel of biomarkers measures inflammation, altered coagulation, and endothelial activation all of which play key roles in the pathogenesis of lung injury.
|
18 hours after the initiation of the first red blood cell transfusion.
|
|
Number of "Off-protocol" Transfusions
Time Frame: Day of surgery. Approximately 1 day.
|
The number of standard issued red blood cell units that were transfused to study participants in the washed red blood cell arm of the trial.
Additionally, emergency red blood cell transfusions in the standard issued arm of the trial that were administered outside of the study protocol were also included to the definition of "off protocol" transfusion.
|
Day of surgery. Approximately 1 day.
|
|
Change in Recipient Hemoglobin
Time Frame: Pre to 6 hours post transfusion
|
Change in Hemoglobin from pre-transfusion to post-transfusion
|
Pre to 6 hours post transfusion
|
|
Change in Recipient Cell Free Hemoglobin(CFH)
Time Frame: Pre transfusion until study day 5 or hospital discharge, approximately 5 days
|
Change in CFH from pre-transfusion to worst (highest/maximum) post-transfusion
|
Pre transfusion until study day 5 or hospital discharge, approximately 5 days
|
|
Change in Haptoglobin
Time Frame: Pre transfusion to study day 5 or hospital discharge, approximately 5 days
|
Change in Haptoglobin from pre-transfusion to worst (minimum) post-transfusion
|
Pre transfusion to study day 5 or hospital discharge, approximately 5 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Duration of Mechanical Ventilation
Time Frame: Up to hospital day 28, or discharge, whichever comes first
|
Number of hours subject received mechanical ventilation.
|
Up to hospital day 28, or discharge, whichever comes first
|
|
Duration of Oxygen Supplementation
Time Frame: Up to day 28, or hospital discharge, whichever comes first
|
Number of hours subjects received supplemental oxygen.
|
Up to day 28, or hospital discharge, whichever comes first
|
|
Sequential Organ Failure Assessment (SOFA) Score
Time Frame: Through postoperative day 5.
|
Worst SOFA score between Day 1 and Day 5. SOFA scores range from 0-24 with 0 meaning no organ dysfunction and 24 means severe dysfunction of all organ systems evaluated.
Each of 6 organ systems are scored on a 0-4 scale with the cumulative score being the total SOFA score.
|
Through postoperative day 5.
|
|
Hospital Length of Stay
Time Frame: Up to day 28
|
Number of days subject remained in the hospital following their surgical procedure.
If the number of days the subject remained in the hospital exceeded 28, a value of 28 is assigned.
|
Up to day 28
|
|
Post Transfusion Respiratory Complications.
Time Frame: Up to day 28
|
Development of transfusion-related lung injury (TRALI) or transfusion-associated circulatory overload (TACO).
|
Up to day 28
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Daryl Kor, MD, Mayo Clinic
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 13-005965
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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