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The aim of our data analysis-based questionnaire study is to assess the daily transfusion practices used in the care of critically ill patients in intensive care units in Hungary.
The rate and frequency of the application of physiological parameters (serum lactate level, central venous oxygen saturation and arteriovenous carbon dioxide difference, arteriovenous oxygen content difference) recommended as transfusion triggers in the international literature in daily practice will be assessed.
The aim of our survey is not only to collect statistical data, but also to map practical experiences, knowledge, opinions and possible institutional differences. Our aim is to obtain a more comprehensive picture of the operation of the care system, including transfusion activities, and any possible different practices applied in individual institutions, based on the experiences and observations of colleagues directly involved in patient care.
The aim of our study is to assess the transfusion practice applied in the care of anemic, critically ill patients in intensive care units in Hungary.
In this study, we examine the rate and frequency of the application of physiological parameters (serum lactate level, central venous oxygen saturation and arteriovenous carbon dioxide difference, arteriovenous oxygen content difference) recommended as transfusion triggers in the international literature in everyday practice.
This is a non-interventional, cross-sectional observational survey study. We use a descriptive, Hungarian-language online questionnaire (Google Forms, Google Inc., Mountain View, CA) survey regarding the transfusion practice of intensive care units in Hungary is based on 15 mandatory and 1 optional question. Participation in the study is completely voluntary and anonymous. No personal or other sensitive data is recorded or stored during the data collection process, so respondents cannot be identified. The names of the responding institutions are registered solely for the purpose of geographical distribution of responses.
The MedCalc statistical analysis software (MedCalc Software bvba, Ostend, Belgium) was used to evaluate the questionnaires, and the results were expressed as a percentage of the number of respondents, using a 95% confidence interval. The normality of the data was checked using the Kolmogorov-Smirnov test. The data were presented as mean ± standard deviation in the case of normal distribution, and median (interquartile range) in the case of non-normal distribution. The relationship between the different subgroups (specialist trainees vs. specialists; university centers vs. public hospitals) was examined using Pearson's correlation. The analysis between the groups was performed using the chi-square test, and the relationship between the use of the PBM program and transfusion triggers was examined using a two-way repeated measures analysis of variance (2-way RM ANOVA). A p<0.05 was considered statistically significant.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hungarian intensivists | Hungarian intensivists |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Survey using a questionnaire. | Other | The questionnaire consists of 15 mandatory and 1 optional question. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The practice of applying physiological parameters that trigger the need for blood transfusion as assessed by the survey questionnaire | The primary endpoint of the study is the use of physiological parameters (serum lactate level, central venous oxygen saturation, arteriovenous carbon dioxide difference and arteriovenous oxygen content difference) indicating oxygen deficiency / oxygen debt underlying tissue oxygenation disorders in determining the indication for red blood cell transfusions in critically ill patients treated in the intensive care unit. | through study completion (2 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Type of departmental transfusion practice | Assessment of the application of restrictive versus liberal transfusion policy | through study completion (2 months) |
| Assessment of the existence and availability of Patient Blood Management (PBM) programs in the respondents' institutions based on the survey questionnaire |
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Inclusion criteria:
- Hungarian anesthesiologists and intensive care practitioners
Exclusion criteria:
- Anesthesiologists and intensive care practitioners working in non-Hungarian intensive care units
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Doctors practicing in Hungarian intensive care units
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| Name | Affiliation | Role |
|---|---|---|
| Zoltán Ruszkai, MD, PhD | Flór Ferenc Hospital Kistarcsa | Study Director |
| Csanád Geréd, MD | Flór Ferenc Hospital Kistarcsa | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Flór Ferenc Hospital Kistarcsa | Kistarcsa | Pest County | 2143 | Hungary |
IPD will not be collected as participation is anonymus.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jun 4, 2025 | Apr 9, 2026 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D000740 | Anemia |
| ID | Term |
|---|---|
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| D001803 | Blood Transfusion |
| ID | Term |
|---|---|
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
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Number of institutions where the PBM program is available and its elements are applied in everyday practice will be reported |
| through study completion (2 months) |
| Correlation between applying the PBM program guidelines and the use of transfusion triggers as assessed by the survey questionnaire | To examine how the application of the PBM guideline affects respondents' daily practices regarding the use of physiological triggers for blood transfusion. | through study completion (2 months) |
| Transfusion protocol | Availability of a written transfusion protocol adapted to the intensive care unit | through study completion (2 months) |