Anaemia management with red Blood Cell transfusion to improve post-intensive care disability: protocol for the ABC post-ICU randomised controlled trial

Abstract

BackgroundAnaemia is prevalent after intensive care unit (ICU) discharge as a consequence of factors such as blood sampling, concurrent inflammation affecting erythropoiesis, and the use of restrictive ICU red blood cell (RBC) transfusion practice during inpatient stay. ICU survivors experience poor health-related quality of life (HRQoL). Prevalent symptoms include fatigue and weakness, to which anaemia may contribute. There are no trials exploring the effectiveness of treating anaemia with RBC transfusions post-ICU discharge.Methods and analysisThe ABC post-ICU trial is a multicentre prospective, parallel group, randomised trial, with embedded moderation and mediation analysis. Participants are adult ICU survivors with anaemia (haemoglobin (Hb) ≤94g/L) fit for ICU discharge. Patients are randomised to usual care (default Hb transfusion trigger 70% completed SF-36 follow-up.Ethical approvalScotland A Research Ethics Committee (REC; Scotland; 19/SS/0105); Wales REC4 (England, Wales; 19/WA/0276) ClinicalTrials.gov: NCT04591574</p