Rygård S L, Jonsson A B, Madsen M B, Perner A, Holst L B, Johansson P I, Wetterslev J
Department of Intensive Care, 4131, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Centre for Research in Intensive Care (CRIC), Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2017 Nov;61(10):1384-1397. doi: 10.1111/aas.12991. Epub 2017 Sep 13.
Patients in the intensive care unit (ICU) are often anaemic due to blood loss, impaired red blood cell (RBC) production and increased RBC destruction. In some studies, more than half of the patients were treated with RBC transfusion. During storage, the RBC and the storage medium undergo changes, which lead to impaired transportation and delivery of oxygen and may also promote an inflammatory response. Divergent results on the clinical consequences of storage have been reported in both observational studies and randomised trials. Therefore, we aim to gather and review the present evidence to assess the effects of shorter vs. longer storage time of transfused RBCs for ICU patients.
We will conduct a systematic review with meta-analyses and trial sequential analyses of randomised clinical trials, and also include results of severe adverse events from large observational studies. Participants will be adult patients admitted to an ICU and treated with shorter vs. longer stored RBC units. We will systematically search the Cochrane Library, MEDLINE, Embase, BIOSIS, CINAHL and Science Citation Index for relevant literature, and we will follow the recommendation by the Cochrane Collaboration and the Preferred Reporting Items for Systemtic Review and Meta-Analysis (PRISMA)-statement. We will assess the risk of bias and random errors, and we will use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to evaluate the overall quality of evidence.
We need a high-quality systematic review to summarise the clinical consequences of RBC storage time among ICU patients.
重症监护病房（ICU）的患者常因失血、红细胞（RBC）生成受损和RBC破坏增加而出现贫血。在一些研究中，超过半数的患者接受了RBC输血治疗。在储存过程中，RBC和储存介质会发生变化，这会导致氧气运输和输送受损，还可能促进炎症反应。观察性研究和随机试验中关于储存的临床后果均报告了不同的结果。因此，我们旨在收集并综述现有证据，以评估输注给ICU患者的RBC储存时间较短与较长时的效果。
我们将对随机临床试验进行系统评价、荟萃分析和试验序贯分析，还将纳入大型观察性研究的严重不良事件结果。参与者将是入住ICU并接受储存时间较短或较长的RBC单位治疗的成年患者。我们将系统检索Cochrane图书馆、MEDLINE、Embase、BIOSIS、CINAHL和科学引文索引以查找相关文献，并遵循Cochrane协作网和系统评价与荟萃分析优先报告项目（PRISMA）声明的建议。我们将评估偏倚风险和随机误差，并使用推荐分级、评估、制定与评价（GRADE）方法来评估证据的总体质量。
我们需要一项高质量的系统评价来总结ICU患者中RBC储存时间的临床后果。
