PABST-BR
Trial question
What is the effect of a multifaceted anemia management bundle in critically ill patients with anemia?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
43.0% female
57.0% male
N = 100
100 patients (43 female, 57 male).
Inclusion criteria: critically ill patients with moderate-to-severe anemia.
Key exclusion criteria: severe anemia preceding hospitalization; receipt of > 10 units of allogeneic RBCs in the preceding 48 hours; use of intravenous iron or ESAs within 30 days; pregnancy; acute thrombosis or myocardial ischemia without revascularization; stroke in the past 3 months; receipt of mechanical circulatory support.
Interventions
N=49 anemia treatment bundle (multifaceted anemia treatment including optimized phlebotomy, clinical decision support, and intravenous iron).
N=51 standard care (standard clinical care).
Primary outcome
Mean hemoglobin concentration at 1 month
12.2 g/dL
11.5 g/dL
12.2 g/dL
9.1 g/dL
6.1 g/dL
3.0 g/dL
0.0 g/dL
Anemia treatment
bundle
Standard
care
Significant
increase ▲
Significant increase in mean hemoglobin concentration at 1 month (12.2 g/dL vs. 11.5 g/dL; MD 0.69, 95% CI 0.13 to 1.2).
Secondary outcomes
No significant difference in RBC transfusion (2% vs. 11.8%; OR 0.16, 95% CI 0.02 to 1.4).
No significant difference in EuroQol-VAS at 1 month (70 points vs. 65 points; OR 1.79, 95% CI 0.76 to 4.2).
No significant difference in Functional Assessment of Chronic Illness Therapy, Fatigue Subscale (41 points vs. 37 points; OR 2.43, 95% CI 0.87 to 6.8).
Conclusion
In critically ill patients with moderate-to-severe anemia, anemia treatment bundle was superior to standard care with respect to mean hemoglobin concentration at 1 month.
Reference
Matthew A Warner, Matthew L Johnson, Andrew C Hanson et al. Practical Anemia Bundle and Hemoglobin Recovery in Critical Illness: A Randomized Clinical Trial. JAMA Netw Open. 2025 Mar 3;8(3):e252353.
Open reference URL