A recent article in The New York Times has revealed transfusions in the US are down almost one-third. One reason cited for declining demand is that recent studies have found many transfusions unnecessary, so patients are no longer getting expensive services that did them no good.
It is work led by CCCTG members that transformed transfusion practice! The ground breaking trial entitled "Transfusion Requirements in Critical Care" (The TRICC Study) led by Paul Hébert was published in the New England Journal of Medicine (NEJM) and cited more than 3000 times. This study has affected how clinicians approach blood transfusion in the critically ill and in other acute care settings worldwide. It provided the first evidence that giving less blood was associated with comparable rates of death and organ failure and fewer complications. A related trial involving critically ill children (the TRICC-PICU Study) co-lead by Jacques Lacroix and Paul Hébert with findings similar to those of the TRICC study was also published in NEJM in 2007.
This seminal work has generated a significant research agenda including studies focused on the use of alternatives to transfusion, blood conservation, resuscitation fluids, cardiac resuscitation and trauma. For example, anemia is very common and associated with worse outcome in critically ill patients suffering from severe neurologic conditions. Shane English is evaluating transfusion thresholds at which one should initiate transfusion and the effect on neurologic functional outcome in patients with brain injury (the SAhARA study). Jacques Lacroix is currently conducting a large international trial (the ABLE Study) in critically ill patients to determine the effect of red blood cell storage on the clinical outcomes of transfusion. Marisa Tucci is leading a parallel study in children (the ABC-PICU Study) to assess the effect of the age of blood during transfusion on the gravity of organ failure.
Read also the recent news feature on transfusion tresholds in Nature.
This is important example on how high impact research conducted by the CCCTG has changed the practice and dramatically improved the care of vulnerable patients with life threatening illnesses.