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tricc trial

Yasemin Hirst, Robert Kerrison, Lindsay C Kobayashi, Nicholas Counsell, Natasha Djedovic, Josephine Ruwende, Mark Stewart, Christian von Wagner
BACKGROUND: Screening with the guaiac faecal occult blood test (gFOBt) is associated with improved colorectal cancer (CRC) survival, and is offered biennially to men and women aged 60-74 years in England's national Bowel Cancer Screening Programme (BCSP). Uptake of the gFOBt is low, with only 54 % of the eligible population completing the test. Text-message reminders could improve uptake of gFOBt. METHODS/DESIGN: This paper describes the protocol for a randomised controlled trial, which will examine the effectiveness of a text-message reminder to promote uptake of gFOBt screening in the BCSP...
2016: BMC Public Health
Lauralyn McIntyre, Alan T Tinmouth, Dean A Fergusson
PURPOSE OF REVIEW: This review summarizes the current evidence base for commonly transfused blood components with a particular focus on the nonacutely bleeding patient. RECENT FINDINGS: There remains little definitive evidence to guide transfusion practices in the critically ill. The most rigorous evidence to guide red blood cell (RBC) transfusion practice is derived from the Transfusion in Critical Care Trial (TRICC Trial) that was published in 1999. Specific subgroups of patients may be at particular risk of the adverse effects of anemia, and require further study...
August 2013: Current Opinion in Critical Care
Michael A Portman, April Slee, Aaron K Olson, Gordon Cohen, Tom Karl, Elizabeth Tong, Laura Hastings, Hitendra Patel, Olaf Reinhartz, Antonio R Mott, Richard Mainwaring, Justin Linam, Sara Danzi
BACKGROUND: Triiodothyronine levels decrease in infants and children after cardiopulmonary bypass. We tested the primary hypothesis that triiodothyronine (T3) repletion is safe in this population and produces improvements in postoperative clinical outcome. METHODS AND RESULTS: The TRICC study was a prospective, multicenter, double-blind, randomized, placebo-controlled trial in children younger than 2 years old undergoing heart surgery with cardiopulmonary bypass...
September 14, 2010: Circulation
Timothy S Walsh
Current evidence suggests that critically ill patients tolerate anaemia well and that blood transfusions may increase the risk of adverse outcomes. Dr Sakr and colleagues present a contradictory analysis of a surgical ICU cohort, finding an association between blood transfusions and lower hospital mortality after adjustment for a range of potential confounders. Analyses of this kind are interesting and provocative, but are limited by residual confounding and bias by indication. The data emphasise the need for additional high quality trials of transfusion practice in critical care...
2010: Critical Care: the Official Journal of the Critical Care Forum
John C Marshall
BACKGROUND: Anemia is a common complication of critical illness. Because tissue hypoxia is a prominent factor in the development of organ dysfunction in the critically ill, conventional wisdom has argued that the transfusion of packed red blood cells can attenuate tissue hypoxia and so improve outcome. METHODS: Review of pertinent English-language literature. RESULTS: The empiric evidence supporting the benefit of transfusion to treat tissue hypoxia is sparse; indeed, a body of recent work suggests that moderate anemia is not only well-tolerated by the critically ill patient, it is associated with improved clinical outcomes...
2005: Surgical Infections
Alistair D Nichol
Many intensive care patients receive red blood cell transfusions. International clinical practice has recently changed, with a decrease in the "trigger" haemoglobin concentration used for red blood cell transfusions in critically ill patients. This change has been driven by increasing awareness of the infectious and non-infectious complications of allogeneic red blood cell transfusion, the perennial blood supply shortages, and most importantly by the Transfusion Requirements in Critical Care (TRICC) study, which suggested that a restrictive transfusion strategy (a transfusion trigger of 70 g/L and a post-transfusion goal of 70-90 g/L) may be equivalent to a liberal transfusion strategy (a transfusion trigger of 100 g/L and a posttransfusion goal of 100-120 g/L) in non-shocked ICU patients...
December 2008: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Marya D Zilberberg, Andrew F Shorr
BACKGROUND: Nearly half of all patients in the Intensive Care Unit (ICU) receive red blood cell (pRBC) transfusions (TFs), despite their associated complications. Restrictive transfusion strategy (Hemoglobin [Hb] < 7 g/dL) has been shown to reduce TF exposure. We estimated the potential annual reduction in transfusion-attributable severe acute complications (TSACs) and costs across the US ICUs with the adoption of restrictive strategy. METHODS: A model, utilizing inputs from published studies, was constructed...
2007: BMC Health Services Research
Katherine J Deans, Peter C Minneci, Anthony F Suffredini, Robert L Danner, William D Hoffman, Xizhong Ciu, Harvey G Klein, Alan N Schechter, Steven M Banks, Peter Q Eichacker, Charles Natanson
OBJECTIVE: Clinical trial designs that randomize patients to fixed treatment regimens may disrupt preexisting relationships between illness severity and level of therapy. The practice misalignments created by such designs may have unintended effects on trial results and safety. METHODS: To illustrate this problem, the Transfusion Requirements in Critical Care (TRICC) trial and the Acute Respiratory Distress Syndrome Network low tidal volume (ARMA) trial were analyzed...
June 2007: Critical Care Medicine
P C Hébert, S Szick
The transfusion of blood products continues to be an important technique for resuscitating patients in intensive care settings. A number of provocative studies have been published in the past year which examine the transfusion of blood products and alternatives. The Transfusion Requirements in Critical Care (TRICC) trial clearly established the safety of a restrictive transfusion strategy, thereby suggesting that physicians could easily minimize exposure to allogeneic red blood cells by lowering their transfusion threshold...
April 2000: Current Opinion in Anaesthesiology
Michael A Portman, Collette Fearneyhough, Tom R Karl, Elizabeth Tong, Kristy Seidel, Antonio Mott, Gordon Cohen, Theresa Tacy, Mark Lewin, Lester Permut, Mary Schlater, Anthony Azakie
BACKGROUND: Cardiopulmonary bypass induces marked and persistent depression of circulating thyroid hormones in infants and children, possibly contributing to postoperative morbidity. Clinical studies have evaluated parenteral triiodothyronine supplementation after cardiopulmonary bypass in children. However, these investigations had relatively small subject numbers as well as age and diagnosis heterogeneity, thereby limiting ability to determine clinical effect. A double-blind, randomized, placebo-controlled trial is needed to define clinical safety and efficacy of triiodothyronine supplementation in infants...
September 2004: American Heart Journal
Lena M Napolitano, Howard L Corwin
This article has evaluated the published data regarding the efficacy of RBC transfusions in the critically ill. Taken together, these studies generally support conservative RBC transfusion strategies in critical care to reduce the risk of transfusion-related adverse effects. The TRICC trial has established the safety ofa restrictive transfusion strategy, suggesting that physicians could minimize exposure to allogeneic RBCs by lowering their transfusion threshold. Further research will add to the generalizability of this study and explore the possible mechanism to explain why RBC transfusions do not improve outcomes in the critically ill...
April 2004: Critical Care Clinics
Paul C Hébert, Bernard J McDonald, Alan Tinmouth
Despite the frequent use of red cell transfusions, only one large randomized trial has examined red cell administration perioperative and in the critical care setting. However, the TRICC Trial does not provide sufficient evidence to determine optimal transfusion practice in postoperative care, in critically ill children, or in patients with a myocardial infarction or acute coronary syndromes. In addition, most transfusion practice guidelines published before the completion of the TRICC Trial are now dated and need to have expert opinion informed by solid evidence in diverse clinical settings...
April 2004: Critical Care Clinics
Paul C Hébert
No abstract text is available yet for this article.
August 2002: Vox Sanguinis
P C Hébert
Transfusion of red blood cells continues to be an important therapy for treatment of anemia in intensive care settings. The critically ill are a population predisposed to the adverse outcomes of anemia and, as such, the risks imposed on them by transfusion therapy is one of great interest. Over the past decade there has been a shift in transfusion practice with guidelines being developed that promote more conservative and safer use of blood. The Transfusion Requirements in Critical Care (TRICC) trial clearly established the safety of a restrictive transfusion strategy, suggesting that physicians could easily minimize exposure to allogeneic RBCs by lowering their transfusion threshold...
2000: Vox Sanguinis
P C Hébert, G Wells, M Tweeddale, C Martin, J Marshall, B Pham, M Blajchman, I Schweitzer, G Pagliarello
In 4,470 critically ill patients, we examined the impact of transfusion practice on mortality rates. As compared with survivors, patients who died in intensive care units (ICU) had lower hemoglobin values (95 +/- 26 versus 104 +/- 23 g/L, p < 0.0001) and were transfused red cells more frequently (42.6% versus 28.0%, p < 0.0001). In patients with cardiac disease, there was a trend toward an increased mortality when hemoglobin values were < 95 g/L (55% versus 42%, p = 0.09) as compared with anemic patients with other diagnoses...
May 1997: American Journal of Respiratory and Critical Care Medicine
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