Clinical trial NCT03019900: Survey of Blood Transfusion Practices in Critically Ill Patients at High Altitude
Official title: Encuesta Sobre prácticas de transfusión de glóbulos Rojos en el Paciente crítico Atendido en Unidades de Altura
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Anemia
Critically Ill
Lead sponsor: Universidad Tecnológica Equinoccial
Sponsor class: OTHER
Collaborators: name: Red Latinoamericana de Medicina Intensiva de Altura
First posted: 2017-01-13
Enrollment: 352
Sex: ALL
Minimum age (years): 30
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The records of the Latin American Intensive Medicine Research Network in high altitude (RELAMI), which has members from Bolivia, Colombia, Ecuador, Mexico and Peru, will be used as a contact source to identify active intensivists through the mailing list of members. Trying to identify intensive care units that work above 1500 meters above sea level.

Brief summary: 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

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

Intensivists who work in intensive care units localized above 1500 meters above sea level

Exclusion Criteria:

* fellows, retired members and pediatrics intensivists

Primary outcomes:
measure: Cross sectional survey.
timeFrame: 1 day
Secondary outcomes:
Other outcomes:
Locations:
city: Quito
country: Ecuador
facility: Nadia Montero
state: Pichincha
Study officials:
affiliation: Universidad Tecnológica Equinoccial
name: Nadia Montero, physician
role: PRINCIPAL_INVESTIGATOR
References: