Guideline Implementation for Blood Transfusion

(TRIP Trial)

Enrolling by invitation at 1 trial location

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Unwilling to participate, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to enhance how doctors and nurses use guidelines to determine when children in intensive care require blood transfusions. Research has shown that many transfusions may cause more harm than good, leading to issues like infections or organ problems. By better implementing these guidelines, specifically for red blood cell transfusions, the trial seeks to reduce unnecessary transfusions and improve health outcomes for critically ill children. Medical professionals working in the pediatric intensive care unit at specific hospitals may be suitable participants. As an unphased trial, this study offers a unique opportunity to contribute to improving pediatric care practices and outcomes.

Do I need to stop my current medications for this trial?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this guideline implementation is safe for pediatric patients?

Research has shown that red blood cell transfusions can sometimes harm children in intensive care. Some studies have found that these transfusions may cause organ problems, infections, confusion, and even increase the risk of death. Due to these risks, experts have developed guidelines to avoid unnecessary transfusions.

This study does not test a new medicine or treatment. Instead, it focuses on using existing guidelines to improve patient care. These guidelines, based on strong clinical evidence, aim to prevent potential harm from transfusions. The goal is to ensure blood transfusions are given only when truly necessary, leading to better outcomes for children in critical care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about implementing Red Blood Cell Transfusion Recommendations because it aims to optimize and standardize transfusion practices. Unlike the traditional approach where transfusions might be given based on varied individual judgments, this guideline-driven method ensures that transfusions are administered only when truly necessary, reducing the risks associated with over-transfusion. This method could lead to better patient outcomes, more efficient use of medical resources, and a reduction in potential complications, making it a promising development in the management of blood transfusions.

What evidence suggests that implementing these transfusion recommendations is effective for reducing unnecessary transfusions in critically ill children?

Studies have shown that red blood cell transfusions can sometimes harm hospitalized children, particularly those in intensive care. To address this, clinical guidelines known as the TAXI recommendations have been developed. These guidelines, based on strong clinical evidence, aim to prevent transfusion-related risks. Research indicates that following these guidelines can reduce the likelihood of organ problems, infections, and even death in seriously ill children. By adhering to these guidelines, hospitals can improve outcomes for young patients by avoiding unnecessary transfusions. ^{1 2 3 5 6}

Are You a Good Fit for This Trial?

This trial is for hospitalized children in the pediatric intensive care unit who may require red blood cell transfusions. The study aims to include those where restrictive transfusion practices could be beneficial, but specific inclusion and exclusion criteria are not detailed.

Inclusion Criteria

Employed at Lucile Packard Children's Hospital at Stanford University or the Children's Hospital of Philadelphia AND employed in one of the following roles: PICU nurse, PICU attending, PICU fellow, PICU resident, PICU advanced practice provider, Other physician or surgeon in subspecialties whose patients regularly receive transfusions in the PICU, PICU TRIP implementation team member, PICU nursing leader, PICU physician leader, Blood bank leader

Exclusion Criteria

Directly report to the primary investigator.

I am not willing to participate in the trial.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

Implementation of targeted efforts to improve adherence to red blood cell transfusion recommendations using CCDS tools

18 months

Follow-up

Participants are monitored for unintended consequences and impact of CCDS tools on quality of care

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Implementation of Red Blood Cell Transfusion Recommendations

Trial Overview The study is testing targeted strategies to better implement existing recommendations on restricting red blood cell transfusions. It seeks to reduce unnecessary transfusions and improve outcomes by encouraging adherence to these guidelines.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Agency for Healthcare Research and Quality (AHRQ)

Collaborator

Trials

415

Recruited

6,777,000+

Children's Hospital of Philadelphia

Collaborator

Trials

749

Recruited

11,400,000+

Lucile Packard Children's Hospital

Collaborator

Trials

16

Recruited

2,800+

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT07108374

Implementation of Red Blood Cell Transfusion ... Evidence demonstrates that the risks of red blood cell transfusions outweigh benefits in many patients who are hospitalized in the pediatric ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6124312/

Implementation of the Recommendations for Red Blood ... The TAXI recommendations on red blood cell transfusions are based on clinical evidence and aim to limit unnecessary and potentially harmful transfusions.

3. journal.chestnet.org journal.chestnet.org/article/S0012-3692(24)05272-3/fulltext

Red Blood Cell Transfusion in Critically Ill Adults - CHEST A panel of experts developed six Population, Intervention, Comparator, and Outcome questions addressing RBC transfusions in critically ill ...

4. acpjournals.org acpjournals.org/doi/10.7326/ANNALS-25-00706

Red Cell Transfusion in Acute Myocardial Infarction The aim of this guideline is to provide recommendations for red blood cell transfusion in patients with AMI. Methods: These guidelines are ...

5. aob.amegroups.org aob.amegroups.org/article/view/11039/html

Impact of red blood cell transfusion on patient's quality of life In conclusion, RBC transfusion therapy plays a crucial role in improving QoL outcomes in patients with thalassemia and SCD by ameliorating ...

6. clinlab.ucsf.edu clinlab.ucsf.edu/sites/g/files/tkssra15786/files/wysiwyg/RBC%20Transfusion%202023%20AABB%20International%20Guidelines.pdf

Red Blood Cell Transfusion 2023 AABB International ... Given heterogeneity in results and an upper CI limit consistent with substantial harm (4.4% rate of increased deaths in the restrictive ...