Blood Component TransfusionPUCSNCT01187394
Plasma Utilization Following Cardiac Surgery
An observational study of Blood Component Transfusion and Cardiac Surgical Procedures, run by Ottawa Hospital Research Institute at 1 site in Canada.
Trial summary
In Canada, 218,000 units of fresh frozen plasma and frozen plasma were transfused in 2005.Cardiac surgery patients are the largest recipient group for FP transfusions. Despite this, no studies have characterized the use of FP in relation to coagulation test abnormalities or bleeding, or how these and other clinical… Read more about this study
- Who is it for?
- Ages 16 years and older
- Conditions the study is for
- Blood Component Transfusion, Cardiac Surgical Procedures
- How many people
- 970 participants
- Where
- 1 siteCanada
- Study dates
- Feb 2011to May 2012
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: Patients at six 6 Canadian Centres
Who may be able to join
- All subjects undergoing Cardiopulmonary Bypass surgery
- More detailed Data Collection for subjects:
- who either receive at least one Frozen Plasma Transfusion or
- who have an INR > 1.2 in the 72 hours following surgery and
- are admitted to an intensive care unit.
Who cannot join
- No subjects undergoing cardiopulmonary bypass surgery will be excluded
Trial locations and contacts
1 site in 1 country.
About this study
In Canada, 218,000 units of fresh frozen plasma and frozen plasma were transfused in 2005.Cardiac surgery patients are the largest recipient group for FP transfusions. Despite this, no studies have characterized the use of FP in relation to coagulation test abnormalities or bleeding, or how these and other clinical determinants influence the decision to transfuse FP. Furthermore, no studies have evaluated the effectiveness of FP transfusions in correcting laboratory abnormalities or treating bleeding in cardiac surgery.
Given the varied use of FP transfusions in cardiac surgery, further studies are essential.In order to improve current utilization of FP, current use must be understood, and the relationship between FP transfusions and the clinical factors that affect the decision to transfuse FP.
Read the detailed description
This study will examine (1) the utilization pattern in the use of FP transfusions, (2) the clinical determinants influencing physician's decision to transfuse and blood loss and (3) coagulation tests in individual cardiac surgery patients. Through greater understanding of the current use of FP in cardiovascular surgery, we can improve its utilization and reduce unnecessary and harmful exposure to blood products.
Objectives: We will describe the incidence and clinical determinants of FP transfusions in cardiac surgery. Secondarily, we will evaluate the relationships between the utilization of FP transfusions and (1) blood loss and (2) coagulation test results.
Methods: All FP transfusions given to cardiac surgery patients intra and postoperatively in the intensive care unit will be reviewed. At the time of the transfusion (intraop) or request (postop) for FP all physicians will complete a short questionnaire evaluating the clinical factors influencing their decision to transfuse. For a sample of postoperative patients with elevated an INR who are not transfused FP, we will have physicians complete a similar short questionnaire evaluating the same clinical factors. Charts of all cardiac surgery patients will be reviewed to capture baseline, intraoperative and postoperative data including demographics, transfusions, blood loss and laboratory results. Charts of patients with INR > 1.2 and/or receiving FP will be reviewed in detail to collect baseline data, intraoperative data, and detailed post operative data including FP transfusions, other blood transfusions, blood loss, lab and coagulation results, and adverse transfusion reactions. Data will collected for duration of stay in intensive care.
Outcomes: The primary outcomes are the (i) the proportion of patients transfused FP and the dose of FP transfused and (2) the importance the clinical determinants influencing the decision to transfuse FP. Secondary outcomes include measures of blood loss (mediastinal chest tube blood loss, change in hemoglobin and number of red blood cell transfusions), changes in coagulation tests results (INR, PTT), the frequency of adverse transfusion reactions, length of ICU and hospital stay, and mortality.
Analysis: The primary analysis will be a descriptive analysis of FP transfusions and the clinical determinants influencing the decision to transfuse FP. A multivariable logistic regression analysis will be performed to examine the variables associated with FP utilization including the postoperative IN, hemoglobin, red cell transfusions and mediastinal chest tube loss in patients transfused FP. The correlation between the physician reported clinical determinants for FP transfusions and blood loss and coagulation test results will be examined by Spearman and Pearson correlations as appropriate , and multiple logistic regression. For the analysis of secondary outcomes, the mean change in blood loss and coagulation test results following FP transfusion will be calculated, and a multivariable regression analysis will be performed to examine the relationship between blood loss, FP transfusions and changes in the INR.
- Keywords
- Frozen Plasma, Fresh Frozen Plasma, Cardiac Surgery, Bleeding, Knowledge Translation
- Medical subject headings
- Hemorrhage
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of Frozen Plasma Transfusion
For FP Transfusions, we will determine the proportion of patients transfused FP for (a) all cardiac surgery patients, (b) for patients with an INR> 1.2, (c) for patients with an INR > 1.5 and (d) for patients with no recent coagulation tests available. We will also determine the number of units and volume (mL/kg) for each transfusion order and the total number of units and volume (mL/kg) transfused in addition to the timing of all units transfused in the first 72 hours after cardiac surgery.
Measured: 1 month
Secondary outcomes (1)
Clinical determinants influencing the decision to transfuse
We will examine seven clinical determinants that may influence the decision to transfuse: (1) change in hemoglobin, (2) ongoing chest tube blood loss, (3) potential future blood loss, (4) INR/PT results, (5) aPTT results, (6) hemodynamic instability, (7) hemodilution. We will capture the importance of these factors using a visual analog scale. The same seven clinical determinants will be examined for patients with an elevated INR who are not transfused FP
Measured: 1 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Aug 2010 (estimated)
- Study startFeb 2011
- Primary completionFeb 2012
- Study completionMay 2012
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Blood Component TransfusionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 970 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ottawa Hospital Research Institute
- Sponsor type
- University, hospital or other
- Collaborators
- Canadian Blood Services, Canadian Institutes of Health Research (CIHR)
- Responsible party
- Sponsor
- Investigators
- Alan T Tinmouth, MD MSc, Principal investigator, Ottawa Hospital Research Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01187394
- Sponsor's protocol ID
- 2009769 01
- Acronym
- PUCS
- Status last verified
- May 2012
- First submitted
- 20 Aug 2010
- Last updated
- 23 May 2012
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 May 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Plasma Utilization Following Cardiac Surgery
- ClinicalTrials.gov ID
- NCT01187394
- Acronym / sponsor ID
- PUCS / 2009769 01
- Keywords
- Frozen Plasma, Fresh Frozen Plasma, Cardiac Surgery, Bleeding, Knowledge Translation
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 970 participants (actual)
- Lead sponsor
- Ottawa Hospital Research InstituteUniversity, hospital or other
- Collaborators
- Canadian Blood Services, Canadian Institutes of Health Research (CIHR)
- Study start
- Feb 2011
- Primary completion
- Feb 2012 (actual)
- Study completion
- May 2012 (actual)
- First posted
- 24 Aug 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In Canada, 218,000 units of fresh frozen plasma and frozen plasma were transfused in 2005.Cardiac surgery patients are the largest recipient group for FP transfusions. Despite this, no studies have characterized the use of FP in relation to coagulation test abnormalities or bleeding, or how these and other clinical determinants influence the decision to transfuse FP. Furthermore, no studies have evaluated the effectiveness of FP transfusions in correcting laboratory abnormalities or treating bleeding in cardiac surgery.
Given the varied use of FP transfusions in cardiac surgery, further studies are essential.In order to improve current utilization of FP, current use must be understood, and the relationship between FP transfusions and the clinical factors that affect the decision to transfuse FP.
Detailed description
This study will examine (1) the utilization pattern in the use of FP transfusions, (2) the clinical determinants influencing physician's decision to transfuse and blood loss and (3) coagulation tests in individual cardiac surgery patients. Through greater understanding of the current use of FP in cardiovascular surgery, we can improve its utilization and reduce unnecessary and harmful exposure to blood products.
Objectives: We will describe the incidence and clinical determinants of FP transfusions in cardiac surgery. Secondarily, we will evaluate the relationships between the utilization of FP transfusions and (1) blood loss and (2) coagulation test results.
Methods: All FP transfusions given to cardiac surgery patients intra and postoperatively in the intensive care unit will be reviewed. At the time of the transfusion (intraop) or request (postop) for FP all physicians will complete a short questionnaire evaluating the clinical factors influencing their decision to transfuse. For a sample of postoperative patients with elevated an INR who are not transfused FP, we will have physicians complete a similar short questionnaire evaluating the same clinical factors. Charts of all cardiac surgery patients will be reviewed to capture baseline, intraoperative and postoperative data including demographics, transfusions, blood loss and laboratory results. Charts of patients with INR > 1.2 and/or receiving FP will be reviewed in detail to collect baseline data, intraoperative data, and detailed post operative data including FP transfusions, other blood transfusions, blood loss, lab and coagulation results, and adverse transfusion reactions. Data will collected for duration of stay in intensive care.
Outcomes: The primary outcomes are the (i) the proportion of patients transfused FP and the dose of FP transfused and (2) the importance the clinical determinants influencing the decision to transfuse FP. Secondary outcomes include measures of blood loss (mediastinal chest tube blood loss, change in hemoglobin and number of red blood cell transfusions), changes in coagulation tests results (INR, PTT), the frequency of adverse transfusion reactions, length of ICU and hospital stay, and mortality.
Analysis: The primary analysis will be a descriptive analysis of FP transfusions and the clinical determinants influencing the decision to transfuse FP. A multivariable logistic regression analysis will be performed to examine the variables associated with FP utilization including the postoperative IN, hemoglobin, red cell transfusions and mediastinal chest tube loss in patients transfused FP. The correlation between the physician reported clinical determinants for FP transfusions and blood loss and coagulation test results will be examined by Spearman and Pearson correlations as appropriate , and multiple logistic regression. For the analysis of secondary outcomes, the mean change in blood loss and coagulation test results following FP transfusion will be calculated, and a multivariable regression analysis will be performed to examine the relationship between blood loss, FP transfusions and changes in the INR.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 16 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Patients at six 6 Canadian Centres
Key inclusion criteria (5 listed)
- All subjects undergoing Cardiopulmonary Bypass surgery
- who either receive at least one Frozen Plasma Transfusion or
- who have an INR > 1.2 in the 72 hours following surgery and
- are admitted to an intensive care unit.
Key exclusion criteria (1 listed)
- No subjects undergoing cardiopulmonary bypass surgery will be excluded
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Incidence of Frozen Plasma Transfusion
Time frame: 1 month
For FP Transfusions, we will determine the proportion of patients transfused FP for (a) all cardiac surgery patients, (b) for patients with an INR> 1.2, (c) for patients with an INR > 1.5 and (d) for patients with no recent coagulation tests available. We will also determine the number of units and volume (mL/kg) for each transfusion order and the total number of units and volume (mL/kg) transfused in addition to the timing of all units transfused in the first 72 hours after cardiac surgery.
1 secondary outcome
Clinical determinants influencing the decision to transfuse
Time frame: 1 month
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 May 2012.
Related trials for Blood Component Transfusion
RecruitingPhase 3
A Study of Elritercept to Treat Anemia in Adults With Very Low, Low, or Intermediate Risk Myelodysplastic Syndromes (MDS) Who Need Regular Blood Transfusions
Myelodysplastic Syndromes
Recruiting
Blood Transfusion Strategies During Major Surgery
Perioperative Red Blood Cell Transfusion
RecruitingObservational study
The Correlation Between Red Cell Transfusion and Complications of Prematurity
Retinopathy of Prematurity (ROP), Bronchopulmonary Dysplasia (BPD)
RecruitingObservational study
Role of Viscoelastometric Testing in the Development and Validation of a Clinical-biological Score for Predicting Bleeding in Patients With Malignant Haematological Disorders and Severe Thrombocytopenia
Thrombocytopenia, Platelet Transfusion
Not yet recruitingObservational study
Patient Blood Management in Obstetrics
Patient Blood Management, Blood Product Transfusion for All Conditions
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Alan T Tinmouth, MD MSc principal investigator
Ottawa Hospital Research Institute
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Blood Component Transfusion and Cardiac Surgical Procedures, run by Ottawa Hospital Research Institute at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 23 May 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of Frozen Plasma Transfusion (time frame: 1 month). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 May 2012.