Ho Juliet, Sibbald William J, Chin-Yee Ian H
Departmentof Medicine, The University of Western Ontario, London, Canada.
Crit Care Med. 2003 Dec;31(12 Suppl):S687-97. doi: 10.1097/01.CCM.0000099349.17094.A3.
To review the literature on red blood cell storage and its relationship to the efficacy of transfusion.
Well-documented changes occur to the red blood cell product during ex vivo storage. These changes include a reduction in red blood cell deformability, altered red blood cell adhesiveness and aggregability, and a reduction in 2,3-diphosphoglycerate and ATP. Bioactive compounds with proinflammatory effects also accumulate in the storage medium. These changes reduce posttransfusion viability of red blood cells. The clinical effects beyond posttransfusion viability are uncertain, but a growing body of evidence suggests that the storage lesion may reduce tissue oxygen availability, have proinflammatory and immunomodulatory effects, and influence morbidity and mortality. There are no published randomized, control trials examining the effect of storage duration on morbidity and mortality. Leukoreduction improves the quality of stored red blood cell products and in some studies has been shown to reduce morbidity and mortality.
Although storage duration influences the quality of red blood cell product, there is currently insufficient evidence to advocate shorter storage periods for red blood cell products.
回顾关于红细胞储存及其与输血疗效关系的文献。
红细胞制品在体外储存期间会发生充分记录的变化。这些变化包括红细胞变形性降低、红细胞黏附性和聚集性改变，以及2,3 - 二磷酸甘油酸和三磷酸腺苷减少。具有促炎作用的生物活性化合物也会在储存介质中积累。这些变化降低了输血后红细胞的存活率。输血后存活率之外的临床影响尚不确定，但越来越多的证据表明储存损伤可能会降低组织氧供应，具有促炎和免疫调节作用，并影响发病率和死亡率。尚无已发表的随机对照试验研究储存时间对发病率和死亡率的影响。白细胞滤除可提高储存红细胞制品的质量，并且在一些研究中已显示可降低发病率和死亡率。
尽管储存时间会影响红细胞制品的质量，但目前尚无足够证据支持缩短红细胞制品的储存期。
