Practical Anemia Bundle for Sustained Blood Recovery (PABST-BR) in critical illness: a protocol for a randomised controlled trial.

Autor:	Warner MA; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA warner.matthew@mayo.edu., Go RS; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA., Schulte PJ; Quantitative Health Sciences, Clinical Trials & Biostatistics, Mayo Clinic, Rochester, Minnesota, USA., Beam WB; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Charnin JE; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Meade L; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Droege KA; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Anderson BK; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Johnson ML; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Karon B; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA., Cheville A; Physical Medicine and Rehabilitation, Mayo Clinic Rochester, Rochester, Minnesota, USA., Gajic O; Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA., Kor DJ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Dec 02; Vol. 12 (12), pp. e064017. Date of Electronic Publication: 2022 Dec 02.
DOI:	10.1136/bmjopen-2022-064017
Abstrakt:	Introduction: Anaemia is highly prevalent in critical illness and is associated with impaired outcomes during and after hospitalisation. However, the impact of interventions designed to attenuate or treat anaemia during critical illness on post-hospitalisation haemoglobin recovery and functional outcomes is unclear. Methods and Analysis: The Practical Anemia Bundle for Sustained Blood Recovery (PABST-BR) clinical trial is a pragmatic, open-label, parallel group, single-centre, randomised clinical trial assessing the impact of a multifaceted anaemia prevention and treatment strategy versus standard care for improvement of haemoglobin concentrations and functional outcomes after critical illness. The intervention, which will be delivered early in critical illness for those with moderate-to-severe anaemia (ie, haemoglobin <100 g/L), includes three components: (1) optimised phlebotomy, (2) clinical decision support and (3) pharmacological anaemia treatment directed at the underlying aetiology of anaemia. In-person assessments will occur at 1 and 3 months post-hospitalisation for laboratory evaluations and multidimensional functional outcome assessments. The primary outcome is differences in haemoglobin concentrations between groups, with secondary endpoints of anaemia-related fatigue, physical function, cognition, mental health, quality of life, phlebotomy volumes and frequency, transfusions, readmissions and mortality through 1-year post-hospitalisation. Ethics and Dissemination: The study has been approved by the Institutional Review Board of the Mayo Clinic in Minnesota, USA. A Data Safety Monitoring Plan has been created in accordance with the policies of the Institutional Review Board and the study funder, the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH). The study will comply with NIH data sharing and dissemination policies. Results will be presented at national and international meetings and published in peer-reviewed journals. Designing and testing strategies to optimise haemoglobin recovery and improve functional outcomes after critical illness remain important research gaps. The PABST-BR trial will inform the development of a larger multicentre clinical trial. Trial Registration Number: NCT05167734. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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