The German Patient Blood Management Network

NCT ID: NCT02147795

Last Updated: 2023-03-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

1000000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-01-31

Study Completion Date

2025-12-31

Brief Summary

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* This epidemiological trial will determine whether the implementation of a PBM program is safe and effective in terms of clinical outcome compared to a pre-implementation cohort
* Primary endpoint is a composite outcome comprising in-hospital myocardial infarction, stroke, acute renal failure, death of any cause, pneumonia and sepsis until discharge from hospital in patients before and after implementation of the PBM program.
* Secondary endpoints are the length of stay on the intensive care unit, total hospital stay and the quantitative utilization of allogeneic RBC units, platelet concentrates, other blood products (e.g. fresh frozen (therapeutic) plasma), coagulations factors, and cell saver systems during hospital stay.
* The primary aim is to prove non-inferiority of the intervention (PBM) group when compared with the control group stratified by center.

Detailed Description

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Background: The transfusion of allogeneic red blood cell units might be associated with increased morbidity and mortality due to infectious, immunological, pulmonary and thromboembolic complications. However, transfusion practice currently varies significantly between hospitals and even between physicians and Patient Blood Management programs have not been implemented nationwide in Germany yet. Patient Blood Management (PBM) concepts aim to identify and optimize patients at risk of allogeneic blood transfusions, to promote blood-sparing techniques and restrictive transfusion practices. A rational use of red blood cell concentrates and safe clinical transfusion practice is mandatory. The purpose of the German PBM network is to evaluate the safety of a standardized, evidence-based Patient Blood management concept.

Study Design and Methods: This epidemiological study is a follow-up of a study that is already being carried out in four German university hospitals. This new prospective, multi-centre trial comprises approximately 20 different hospitals of varying size and levels of patient care. A patient-centred, evidence-based Patient Blood Management program will be enrolled in each of these hospitals reforming the care of adult patients undergoing any type of surgery. This PBM program includes the following three main pillars: 1) preoperative optimization of hemoglobin levels in high-risk patients with anaemia, 2) standardization of transfusion practice and transfusion triggers according to evidence-based guidelines and 3) alternatives to transfusion of allogeneic RBC concentrates and blood-sparing techniques (like routine use of cell saver systems, point-of-care diagnostics, optimized coagulation management, restrictive blood sampling).

Conditions

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Clinical Safety of a PBM Program

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Control cohort

Standard care before implementation (pre-implementation)

No interventions assigned to this group

PBM cohort

After implementation of PBM program (post-implementation)

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* all surgeries with a general or local anaesthetic
* minimum hospital stay of 24 h
* ≥ 18 years

Exclusion Criteria

* \< 18 years
* ophthalmologic or dermatologic or outpatient surgery
* all non-surgical anesthetic procedures
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Vifor Pharma

INDUSTRY

Sponsor Role collaborator

B. Braun Melsungen AG

INDUSTRY

Sponsor Role collaborator

CSL Behring

INDUSTRY

Sponsor Role collaborator

Fresenius Kabi

INDUSTRY

Sponsor Role collaborator

Johann Wolfgang Goethe University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Professor Kai Zacharowski, M.D., Ph.D., FRCA

Professor Kai Zacharowski, M.D., Ph.D., FRCA

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Goethe University Hospital

Frankfurt am Main, Hesse, Germany

Site Status RECRUITING

University Hospital Würzburg

Würzburg, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Kai D Zacharowski, Prof, MD, PhD

Role: CONTACT

0049 69 6301 ext. 5998

Patrick Meybohm, M.D

Role: CONTACT

0049 6906301 ext. 5998

Facility Contacts

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Kai Zacharowski, MD PhD

Role: primary

+49-69-6301-5998

Patrick Meybohm, MD

Role: primary

References

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Meybohm P, Schmitt E, Choorapoikayil S, Hof L, Old O, Muller MM, Geisen C, Seifried E, Baumhove O, de Leeuw van Weenen S, Bayer A, Friederich P, Brautigam B, Friedrich J, Gruenewald M, Elke G, Molter GP, Narita D, Raadts A, Haas C, Schwendner K, Steinbicker AU, Jenke DJ, Thoma J, Weber V, Velten M, Wittmann M, Weigt H, Lange B, Herrmann E, Zacharowski K; German Patient Blood Management Network Collaborators. German Patient Blood Management Network: effectiveness and safety analysis in 1.2 million patients. Br J Anaesth. 2023 Sep;131(3):472-481. doi: 10.1016/j.bja.2023.05.006. Epub 2023 Jun 26.

Reference Type DERIVED
PMID: 37380568 (View on PubMed)

Schmitt E, Meybohm P, Neef V, Baumgarten P, Bayer A, Choorapoikayil S, Friederich P, Friedrich J, Geisen C, Guresir E, Grunewald M, Gutjahr M, Helmer P, Herrmann E, Muller M, Narita D, Raadts A, Schwendner K, Seifried E, Stark P, Steinbicker AU, Thoma J, Velten M, Weigt H, Wiesenack C, Wittmann M, Zacharowski K, Piekarski F; German PBM Network Collaborators. Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage - a multicentre subanalysis of the German PBM Network Registry. Acta Neurochir (Wien). 2022 Apr;164(4):985-999. doi: 10.1007/s00701-022-05144-7. Epub 2022 Feb 26.

Reference Type DERIVED
PMID: 35220460 (View on PubMed)

Other Identifiers

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PBM01

Identifier Type: -

Identifier Source: org_study_id

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