Journal article

Safety of a Restrictive versus Liberal Approach to Red Blood Cell Transfusion on the Outcome of AKI in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial

Amit X Garg, Neal Badner, Sean M Bagshaw, Meaghan S Cuerden, Dean A Fergusson, Alexander J Gregory, Judith Hall, Gregory MT Hare, Boris Khanykin, Shay McGuinness, Chirag R Parikh, Pavel S Roshanov, Nadine Shehata, Jessica M Sontrop, Summer Syed, George Tagarakis, Kevin E Thorpe, Subodh Verma, Ron Wald, Richard P Whitlock Show all

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | AMER SOC NEPHROLOGY | Published : 2019

Abstract

BACKGROUND: Safely reducing red blood cell transfusions can prevent transfusion-related adverse effects, conserve the blood supply, and reduce health care costs. Both anemia and red blood cell transfusion are independently associated with AKI, but observational data are insufficient to determine whether a restrictive approach to transfusion can be used without increasing AKI risk. METHODS: In a prespecified kidney substudy of a randomized noninferiority trial, we compared a restrictive threshold for red blood cell transfusion (transfuse if hemoglobin<7.5 g/dl, intraoperatively and postoperatively) with a liberal threshold (transfuse if hemoglobin<9.5 g/dl in the operating room or intensive c..

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Grants

Awarded by Kidney Foundation of Canada


Awarded by National Institutes of Health


Awarded by NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES


Awarded by NATIONAL HEART, LUNG, AND BLOOD INSTITUTE


Funding Acknowledgements

The Transfusion Requirements in Cardiac Surgery-III (TRICS-III) kidney substudy was funded by the Kidney Foundation of Canada (KFOC180004). The main TRICS-III trial was funded by the Canadian Institutes of Health Research, the Canadian Blood Services-Health Canada (the Kenneth J. Fyke Award to Dr. Shehata), the National Health and Medical Research Council of Australia, and the Health Research Council of New Zealand. Dr. Garg was supported by the Dr. Adam Linton Chair in Kidney Health Analytics and a Canadian Institutes of Health Research Clinician Investigator Award, Dr. Sean M Bagshaw was supported by a Canada Research Chair in Critical Care Nephrology, and Dr. Parikh was supported by the National Institutes of Health (RO1HL085757).