Van Haren, FrankObonyo, Nchafatso GByrne, LiamTung, John-PaulSimonova, GabrielaDiab, SaraDunster, KimblePassmore, MargaretBoon, Ai ChingHoe, Louise SeeEngkilde-Pedersen, SanneEsguerra-Lallen, Arlanna2021-02-072021-02-072215-0161http://hdl.handle.net/1885/222370The Surviving Sepsis Campaign (SCC) and the American College of Critical Care Medicine (ACCM) guidelines recommend blood transfusion in sepsis when the haemoglobin concentration drops below 7.0 g/dL and 10.0 g/dL respectively, while the World Health Organisation (WHO) guideline recommends transfusion in septic shock ‘if intravenous (IV) fluids do not maintain adequate circulation’, as a supportive measure of last resort. Volume expansion using crystalloid and colloid fluid boluses for haemodynamic resuscitation in severe illness/sepsis, has been associated with adverse outcomes in recent literature. However, the volume expansion effect(s) following blood transfusion for haemodynamic circulatory support, in severe illness remain unclear with most previous studies having focused on evaluating effects of either different RBC storage durations (short versus long duration) or haemoglobin thresholds (low versus high threshold) pre-transfusion. We describe the protocol for a pre-clinical randomised controlled trial designed to examine haemodynamic effect(s) of early volume expansion using packed RBCs (PRBCs) transfusion (before any crystalloids or colloids) in a validated ovine-model of hyperdynamic endotoxaemic shock. Additional exploration of mechanisms underlying any physiological, haemodynamic, haematological, immunologic and tissue specific-effects of blood transfusion will be undertaken including comparison of effects of short (5 days) versus long ( 30 days) storage duration of PRBCs prior to transfusion.National Health and Medical Research Council, NHMRC, Australia (Grant ID APP1061382), Emergency Medicine Foundation, EMF, Australia (Grant ID EMPJ-358R25-2016), Australian Red Cross Blood Service. Nchafatso G. Obonyo is supported and funded through the DELTAS Africa Initiative [DEL-15-003]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [107769/Z/10/Z] and the UK government.application/pdfen-AU© 2019 The Author(s).http://creativecommons.org/licenses/by/4.0/Blood transfusionSepsisEndotoxaemic shockPacked red blood cells (PRBCs)GuidelinesHaemoglobin thresholdStorage duration201910.1016/j.mex.2019.05.0052020-11-02CC BY license