TRICS IV
Research type
Research Study
Full title
Transfusion Requirements in Younger Patients Undergoing Cardiac Surgery
IRAS ID
325425
Contact name
Gavin Murphy
Contact email
Sponsor organisation
St Michael’s Hospital and Mount Sinai Hospital
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Heart surgery is one of the most frequent surgical procedures and 50% of patients having heart surgery are <65 years of age. During heart surgery, the use of a heart-lung machine and blood loss typically leads to anaemia. Anaemia occurs when there are lower than normal levels of red blood cells (RBCs) and haemoglobin, which carries oxygen to the rest of the body so that it can remain healthy and work properly. Anaemia could potentially lead to heart attack, kidney failure, stroke, or death.
To lower the risks associated with anaemia during and after heart surgery, there is a very high chance that patients will need to receive a red blood cell transfusion (meaning that donated blood will be provided to you through a vein in their arm).
A similar trial (TRICS III) was recently completed. It included about 5000 patients aged >18 years undergoing heart surgery using the heart-lung machine, comparing the restrictive transfusion strategy to the liberal transfusion strategy. The results of this study showed that the restrictive transfusion strategy was favoured in elderly patients, but we don’t know yet which transfusion strategy is best for younger patients.
TRICS IV will help us see if there is a difference in health outcomes in patients between the ages of 18-65 who receive red blood cell transfusions based on the ‘liberal’ versus ‘restrictive’ transfusion strategies. The ’restrictive’ strategy will use a lower haemoglobin level, and the ‘liberal’ strategy will use a higher haemoglobin level for transfusion triggers. If a restrictive transfusion strategy in younger patients might lead to harm, a study is needed to make sure that these patients are given a transfusion at an appropriate haemoglobin level. If younger patients are not experiencing harm from a restrictive transfusion strategy, then they should not be exposed to the risk of being transfused unnecessarily.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
23/WM/0128
Date of REC Opinion
4 Aug 2023
REC opinion
Further Information Favourable Opinion