Use of Pediatric Size Phlebotomy Tubes in Adult Critically Ill Patients to Reduce Red Blood Cell Transfusions

The University of Texas System (UT)

Status: Completed

Conditions: Anemia

Treatments: Device: Pediatric phlebotomy tubes; Device: Adult phlebotomy tubes

Study type: Interventional

Funder types: Other

Identifiers

NCT03286465

HSC-MS-17-0280

Details and patient eligibility

About

This study will evaluate the hypothesis that the use of pediatric size phlebotomy tubes reduces red blood cell (RBC) transfusions in adult intensive care unit (ICU) patients compared with the use of adult size tubes.

Enrollment: 200 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• New admission to the medical or transplant ICU at Memorial Hermann Hospital in Houston
• ICU admission hemoglobin level of at least 7 g/dL. The ICU admission hemoglobin will be the most recent hemoglobin value available at the time of screening for inclusion in the study.
• Randomization is expected within 12 hour of admission to the ICU

Exclusion criteria

• Clinical bleeding. Defined as menstrual bleeding, bleeding leading to a change in the frequency of hemoglobin monitoring or to an order for a medication, transfusion, procedure, or consultation intended to prevent or treat bleeding.
• Known hemolytic disorder (e.g. sickle cell disease, hereditary spherocytosis, autoimmune hemolytic anemia)
• Bone marrow disorder (e.g. aplastic anemia, marrow infiltration disorder, chemotherapy within the last 8 weeks)
• Jehovah's Witnesses
• Patient is comfort care measures only
• Refractory shock: mean arterial blood pressure below 60 mmHg despite maximal doses of 3 vasopressors. Maximal dose of vasopressors are as follows: Norepinephrine 70 mcg/min; vasopressin 0.04 units/min; epinephrine 35 mcg/min; dopamine 20 mcg/kg/min; phenylephrine 350 mcg/min
• Severe acidosis: potential of hydrogen (pH) below 7 in more than one arterial blood gas within 24 hours of ICU admission in the absence of diabetic ketoacidosis Surgical admission diagnosis
• Pregnancy
• Current prisoner

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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200 participants in 2 patient groups

Pediatric phlebotomy tubes

Experimental group

Description:

Use of pediatric size tubes for diagnostic blood collection.

Treatment:

Device: Pediatric phlebotomy tubes

Adult phlebotomy tubes

Active Comparator group

Description:

Use of adult size tubes for diagnostic blood collection.

Treatment:

Device: Adult phlebotomy tubes