Pre-clinical study protocol: Blood transfusion in endotoxaemic shock

Area of Science:

• Critical Care Medicine
• Transfusion Medicine
• Hemodynamics

Background:

• Current sepsis guidelines offer varied recommendations for blood transfusion thresholds.
• Volume expansion with crystalloids/colloids in sepsis is linked to adverse outcomes.
• Hemodynamic effects of early packed red blood cell (PRBC) transfusion in sepsis remain unclear.

Purpose of the Study:

• To describe a preclinical randomized controlled trial protocol.
• To examine the hemodynamic effects of early PRBC transfusion as initial volume expansion in a sepsis model.
• To explore underlying physiological, hematological, immunological, and tissue-specific mechanisms of PRBC transfusion.

Main Methods:

• Utilizing a validated ovine model of hyperdynamic endotoxemic shock.
• Designing a preclinical randomized controlled trial.
• Comparing early PRBC transfusion (before crystalloids/colloids) with other resuscitation strategies.
• Investigating effects of short (≤5 days) versus long (≥30 days) PRBC storage durations.

Main Results:

• This section will report findings from the described preclinical trial once completed.

Conclusions:

• This study protocol provides a framework for investigating the role of early PRBC transfusion in sepsis resuscitation.
• Findings may inform future clinical guidelines on transfusion strategies for septic shock.