Liberal Versus Restrictive Transfusion Strategy in Critically Ill Oncologic Patients: The Transfusion Requirements in Critically Ill Oncologic Patients Randomized Controlled Trial

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBERGAMIN, Fabricio S.
dc.contributor.authorALMEIDA, Juliano P.
dc.contributor.authorLANDONI, Giovanni
dc.contributor.authorGALAS, Filomena R. B. G.
dc.contributor.authorFUKUSHIMA, Julia T.
dc.contributor.authorFOMINSKIY, Evgeny
dc.contributor.authorPARK, Clarice H. L.
dc.contributor.authorOSAWA, Eduardo A.
dc.contributor.authorDIZ, Maria P. E.
dc.contributor.authorOLIVEIRA, Gisele Q.
dc.contributor.authorFRANCO, Rafael A.
dc.contributor.authorNAKAMURA, Rosana E.
dc.contributor.authorALMEIDA, Elisangela M.
dc.contributor.authorABDALA, Edson
dc.contributor.authorFREIRE, Maristela P.
dc.contributor.authorFILHO, Roberto K.
dc.contributor.authorAULER JR., Jose Otavio C.
dc.contributor.authorHAJJAR, Ludhmila A.
dc.date.accessioned2017-06-09T15:17:19Z
dc.date.available2017-06-09T15:17:19Z
dc.date.issued2017
dc.description.abstractObjective: To assess whether a restrictive strategy of RBC transfusion reduces 28-day mortality when compared with a liberal strategy in cancer patients with septic shock. Design: Single center, randomized, double-blind controlled trial. Setting: Teaching hospital. Patients: Adult cancer patients with septic shock in the first 6 hours of ICU admission. Interventions: Patients were randomized to the liberal (hemoglobin threshold, < 9 g/dL) or to the restrictive strategy (hemoglobin threshold, < 7 g/dL) of RBC transfusion during ICU stay. Measurements and Main Results: Patients were randomized to the liberal (n = 149) or to the restrictive transfusion strategy (n = 151) group. Patients in the liberal group received more RBC units than patients in the restrictive group (1 [0-3] vs 0 [0-2] unit; p<0.001). At 28 days after randomization, mortality rate in the liberal group (primary endpoint of the study) was 45% (67 patients) versus 56% (84 patients) in the restrictive group (hazard ratio, 0.74; 95% CI, 0.53-1.04; p = 0.08) with no differences in ICU and hospital length of stay. At 90 days after randomization, mortality rate in the liberal group was lower (59% vs 70%) than in the restrictive group (hazard ratio, 0.72; 95% CI, 0.53-0.97; p = 0.03). Conclusions: We observed a survival trend favoring a liberal transfusion strategy in patients with septic shock when compared with the restrictive strategy. These results went in the opposite direction of the a priori hypothesis and of other trials in the field and need to be confirmed.
dc.description.indexMEDLINE
dc.identifier.citationCRITICAL CARE MEDICINE, v.45, n.5, p.766-773, 2017
dc.identifier.doi10.1097/CCM.0000000000002283
dc.identifier.eissn1530-0293
dc.identifier.issn0090-3493
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/19904
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartofCritical Care Medicine
dc.rightsrestrictedAccess
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINS
dc.subjectcritically ill oncology
dc.subjectintensive care
dc.subjectrandomized controlled trial
dc.subjecttransfusion
dc.subject.otherseptic shock
dc.subject.otherblood-transfusion
dc.subject.othersevere sepsis
dc.subject.othercancer-patients
dc.subject.othercritical-care
dc.subject.othermortality
dc.subject.othermulticenter
dc.subject.otherepidemiology
dc.subject.otherdefinitions
dc.subject.othermanagement
dc.subject.wosCritical Care Medicine
dc.titleLiberal Versus Restrictive Transfusion Strategy in Critically Ill Oncologic Patients: The Transfusion Requirements in Critically Ill Oncologic Patients Randomized Controlled Trial
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryisoit
hcfmusp.author.externalLANDONI, Giovanni:IRCCS San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Milan, Italy
hcfmusp.author.externalFOMINSKIY, Evgeny:IRCCS San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Milan, Italy
hcfmusp.citation.scopus71
hcfmusp.contributor.author-fmusphcFABRICIO SANCHEZ BERGAMIN
hcfmusp.contributor.author-fmusphcJULIANO PINHEIRO DE ALMEIDA
hcfmusp.contributor.author-fmusphcFILOMENA REGINA BARBOSA GOMES GALAS
hcfmusp.contributor.author-fmusphcJULIA TIZUE FUKUSHIMA
hcfmusp.contributor.author-fmusphcCLARICE HYESUK LEE PARK
hcfmusp.contributor.author-fmusphcEDUARDO ATSUSHI OSAWA
hcfmusp.contributor.author-fmusphcMARIA DEL PILAR ESTEVEZ DIZ
hcfmusp.contributor.author-fmusphcGISELE QUEIROZ DE OLIVEIRA
hcfmusp.contributor.author-fmusphcRAFAEL ALVES FRANCO
hcfmusp.contributor.author-fmusphcROSANA ELY NAKAMURA
hcfmusp.contributor.author-fmusphcELISANGELA PINTO MARINHO DE ALMEIDA
hcfmusp.contributor.author-fmusphcEDSON ABDALA
hcfmusp.contributor.author-fmusphcMARISTELA PINHEIRO FREIRE
hcfmusp.contributor.author-fmusphcROBERTO KALIL FILHO
hcfmusp.contributor.author-fmusphcJOSE OTAVIO COSTA AULER JUNIOR
hcfmusp.contributor.author-fmusphcLUDHMILA ABRAHAO HAJJAR
hcfmusp.description.beginpage766
hcfmusp.description.endpage773
hcfmusp.description.issue5
hcfmusp.description.volume45
hcfmusp.origemWOS
hcfmusp.origem.pubmed28240687
hcfmusp.origem.scopus2-s2.0-85014043870
hcfmusp.origem.wosWOS:000399522200003
hcfmusp.publisher.cityPHILADELPHIA
hcfmusp.publisher.countryUSA
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hcfmusp.scopus.lastupdate2024-04-12
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