Badhan Abhitesh, Kaur Paramjit, Mitra Sukanya, Sood Tanvi, Kaur Ravneet, Mittal Kshitija
Department of Transfusion Medicine, Government Medical College and Hospital, Sector 32-B, Chandigarh, 160030 India.
Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Sector 32-B, Chandigarh, 160030 India.
Indian J Hematol Blood Transfus. 2024 Jul;40(3):460-468. doi: 10.1007/s12288-024-01737-7. Epub 2024 Feb 24.
Anemia in critically ill patients requires red cell transfusions to increase oxygen delivery and prevent deleterious outcomes. The primary objective of the present study was to determine the effect of storage age of transfused red cells on 30-day mortality in critically ill patients, with secondary objectives of determining the effect on length of stay, organ failure, and adverse transfusion reactions. This prospective study was conducted on patients admitted to the intensive care unit after obtaining approval from institutional ethics committee. Patients were randomized to transfusion with packed red blood cells (PRBC) with age of collection either ≤ 14 days (Group 1) or > 14 days (Group 2). APACHE II scores were calculated at admission. Patients were followed up for primary outcome of 30-day mortality, and secondary outcomes including length of stay, infections, organ dysfunction, and adverse transfusion reactions. The 30-day mortality was 20% in Group 1 and 28% in Group 2 ( = 0.508). The mean storage duration of PRBC in Group 1 versus Group 2 was 8.48 days versus 21.43 days ( < 0.001). There was no significant difference in total number of PRBC transfusions, donor exposures, hemoglobin and hematocrit increment, adverse transfusion reactions, length of stay and organ dysfunction scores between the two groups. Transfusion of packed red cells of less than 14 days showed no benefit over red cells stored more than 14 days in terms of 30-day mortality, length of stay and infections in critically ill patients, however studies with larger sample size and longer follow up are recommended.
重症患者的贫血需要输注红细胞以增加氧输送并预防有害后果。本研究的主要目的是确定输注红细胞的储存年龄对重症患者30天死亡率的影响，次要目的是确定对住院时间、器官功能衰竭和不良输血反应的影响。本前瞻性研究在获得机构伦理委员会批准后，对入住重症监护病房的患者进行。患者被随机分为输注采集年龄≤14天的浓缩红细胞（PRBC）组（第1组）或>14天的组（第2组）。入院时计算急性生理与慢性健康状况评分系统（APACHE II）得分。对患者进行随访，观察30天死亡率这一主要结局，以及包括住院时间、感染、器官功能障碍和不良输血反应等次要结局。第1组的30天死亡率为20%，第2组为28%（P = 0.508）。第1组与第2组PRBC的平均储存时间分别为8.48天和21.43天（P<0.001）。两组之间在PRBC输注总数、接触献血者次数、血红蛋白和血细胞比容增加值、不良输血反应、住院时间和器官功能障碍评分方面无显著差异。就30天死亡率、住院时间和感染而言，输注储存时间少于14天的浓缩红细胞对重症患者并不比储存时间超过14天的红细胞更有益，不过建议开展样本量更大、随访时间更长的研究。
