Edelstein Steven B
Loyola University Medical Center, Maywood, IL 60153, USA.
Semin Cardiothorac Vasc Anesth. 2012 Sep;16(3):160-5. doi: 10.1177/1089253212445488. Epub 2012 May 3.
Red blood cell transfusion therapy has been used with the ultimate goal of enhancing oxygen delivery to vital organs and tissue beds, thus enhancing cellular function. Red blood cell transfusion therapy is also a long-standing practice, and since the 1950s it has only grown in utilization, especially within the United States. Recently, transfusion therapy has come under increased scrutiny with a desire to develop evidence-based therapeutic guidelines that not only decrease undue risk to the patient but also decrease the overutilization of this high-cost, low-availability product. Despite the development and implementation of these guidelines, significant complications associated with red cell therapy persist and may be related to storage of blood products. Recently, within the transfusion literature, there has been a renewed focus on red cell storage lesions and their contributions to perioperative outcomes. Several meta-analyses, and now a recently launched, multinational randomized controlled trial, have been initiated to help bring clarity to whether or not the length of product storage has any effect on patient outcomes. This review will focus on the nature of storage lesions, complications associated with storage, as well as a brief review of some of the more provocative literature surrounding this controversial topic.
红细胞输血疗法的最终目标是增强向重要器官和组织床的氧气输送，从而增强细胞功能。红细胞输血疗法也是一种长期存在的做法，自20世纪50年代以来，其应用一直在增加，尤其是在美国。最近，输血疗法受到了越来越多的审视，人们希望制定基于证据的治疗指南，这不仅能降低患者面临的不当风险，还能减少这种高成本、低可用性产品的过度使用。尽管制定并实施了这些指南，但与红细胞疗法相关的重大并发症仍然存在，并且可能与血液制品的储存有关。最近，在输血文献中，人们重新关注红细胞储存损伤及其对围手术期结果的影响。已经开展了几项荟萃分析，现在还有一项新启动的多国随机对照试验，以帮助弄清楚产品储存时间是否对患者结果有任何影响。本综述将重点关注储存损伤的性质、与储存相关的并发症，以及对围绕这一有争议话题的一些更具争议性的文献进行简要回顾。
