Department of Anesthesiology, German Heart Institute, Charité University Medicine Berlin, Berlin, Germany.
Department of Anesthesiology, German Heart Institute, Charité University Medicine Berlin, Berlin, Germany ; Department of Physiology, Charité University Medicine Berlin, Berlin, Germany.
Transfus Med Hemother. 2014 Apr;41(2):146-51. doi: 10.1159/000357998. Epub 2014 Feb 17.
Recommendations on the use of fresh red blood cells (RBCs) in pediatric patients undergoing cardiac surgery are based on limited information. Furthermore, the RBC storage time cut-off of fresh units remains unknown.
Data from 139 pediatric patients who underwent cardiac surgery and received RBCs from a single unit within 14 days of storage were analyzed. To identify the optimal cut-off storage time of RBCs for transfusion, multiple multivariate analyses aimed at different outcome parameters were performed.
26 patients received RBC units stored for ≤3 days, while 126 patients received RBCs that were stored for 4-14 days. The latter group required more RBC transfusions and fresh frozen plasma (FFP) than the former group (19 vs. 25 ml/kg, p = 0.003 and 73% vs. 35%, p = 0.0006, respectively). In addition, the odds for the administration of FFP increased with the transfusion of RBCs stored for more than 4 days. The optimal cut-off for post-operative morbidity was observed with a storage time of ≤6 days for length of ventilation (p = 0.02) and peak of C-reactive protein (CRP; p = 0.008).
The obtained results indicate that the hazard of blood transfusion increased with increasing storage time of RBCs. The results of this study suggest that transfusion of fresh RBCs with a storage time of ≤2 or 4 days (concerning transfusion requirements) or ≤6 days (concerning postoperative morbidity) may be beneficial in pediatric patients undergoing cardiac surgery. However, further prospective randomized studies are required in order to draw any final conclusions.
关于在接受心脏手术的儿科患者中使用新鲜红细胞（RBC）的建议基于有限的信息。此外，新鲜单位的 RBC 储存时间截止点仍然未知。
分析了 139 名接受心脏手术并在储存后 14 天内接受单个单位 RBC 的儿科患者的数据。为了确定输血的最佳 RBC 储存时间截止点，针对不同的结果参数进行了多次多变量分析。
26 名患者接受了储存≤3 天的 RBC 单位，而 126 名患者接受了储存 4-14 天的 RBC。后者组比前者组需要更多的 RBC 输血和新鲜冷冻血浆（FFP）（19 与 25ml/kg，p=0.003 和 73%与 35%，p=0.0006）。此外，随着储存超过 4 天的 RBC 输血，输注 FFP 的可能性增加。观察到术后发病率的最佳截止时间为储存时间≤6 天，用于通气时间（p=0.02）和 C 反应蛋白（CRP）峰值（p=0.008）。
获得的结果表明，随着 RBC 储存时间的增加，输血的风险增加。本研究的结果表明，在接受心脏手术的儿科患者中，输注储存时间≤2 或 4 天（关于输血需求）或≤6 天（关于术后发病率）的新鲜 RBC 可能是有益的。然而，需要进一步的前瞻性随机研究以得出任何最终结论。
