Alternative Physiological Transfusion Triggers, Anemia, Blood Transfusion, Cancer, Hemoglobin
Conditions
Keywords
anemia, red blood cell transfusion, physiologic transfusion trigger, alternative transfusion trigger, oxygen extraction ratio, central venous oxygen saturation
Brief summary
This is a prospective, single-center observational study conducted at the Kazakh Institute of Oncology and Radiology. The study included 107 clinically stable adult patients with cancer who required red blood cell transfusion based on a restrictive hemoglobin threshold. The aim of the study was to evaluate alternative physiological indicators of transfusion need and effectiveness. Measurements included oxygen extraction ratio (O₂ER), central venous oxygen saturation (ScvO₂), partial pressure of oxygen in central venous blood (PvO₂), arterio-venous oxygen difference (A-VO₂diff), lactate, and veno-arterial carbon dioxide difference (ΔCO₂). These parameters were assessed before and one hour after transfusion. For data analysis, patients were stratified into two groups based on their baseline O₂ER (≤35.4% and \>35.4%) to evaluate whether higher O₂ER is associated with more pronounced physiological response to transfusion.
Interventions
PROCEDURERed blood cell transfusion
Standard red blood cell transfusion performed as part of routine clinical care. All participants received one or more units of RBCs based on a restrictive hemoglobin threshold. The transfusion protocol was not altered for the purpose of the study.
Sponsors
Ardak Arynov
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult cancer patients (age 18 years or older) * Hemodynamically stable * Not requiring any form of respiratory support * Presence of a central venous catheter inserted into the superior vena cava
Exclusion criteria
* Hemodynamic instability requiring inotropic or vasopressor support * Active bleeding * Shock of any etiology * Patient refusal to participate in the study * Hematological malignancies * Age under 18 years * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Oxygen Extraction Ratio (O₂ER) | Baseline and 1 hour post-transfusion | Difference in oxygen extraction ratio measured before and one hour after red blood cell transfusion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Partial Pressure of Oxygen in Central Venous Blood (PvO₂) | Baseline and 1 hour post-transfusion | Difference in PvO₂ measured before and one hour after transfusion |
| Change in Central Venous Oxygen Saturation (ScvO₂) | Baseline and 1 hour post-transfusion | Difference in ScvO₂ measured before and one hour after transfusion |
| Change in Lactate Concentration | Baseline and 1 hour post-transfusion | Difference in serum lactate measured before and one hour after transfusion |
| Change in Arterio-Venous Oxygen Difference (A-VO₂diff) | Baseline and 1 hour post-transfusion | Difference in arteriovenous oxygen difference measured before and one hour after transfusion |
| Change in Veno-Arterial Carbon Dioxide Difference (ΔCO₂) | Baseline and 1 hour post-transfusion | Difference in ΔCO₂ measured before and one hour after transfusion |
Countries
Kazakhstan
Outcome results
None listed