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| Item Type: | Article |
|---|---|
| Title: | Age of red cells for transfusion and outcomes in patients with ARDS |
| Creators Name: | Graw, J.A., Bünger, V., Materne, L.A., Krannich, A., Balzer, F., Francis, R.C.E., Pruß, A., Spies, C.D., Kuebler, W.M., Weber-Carstens, S., Menk, M. and Hunsicker, O. |
| Abstract: | Packed red blood cells (PRBCs), stored for prolonged intervals, might contribute to adverse clinical outcomes in critically ill patients. In this study, short-term outcome after transfusion of PRBCs of two storage duration periods was analyzed in patients with Acute Respiratory Distress Syndrome (ARDS). Patients who received transfusions of PRBCs were identified from a cohort of 1044 ARDS patients. Patients were grouped according to the mean storage age of all transfused units. Patients transfused with PRBCs of a mean storage age ≤ 28 days were compared to patients transfused with PRBCs of a mean storage age > 28 days. The primary endpoint was 28-day mortality. Secondary endpoints included failure-free days composites. Two hundred and eighty-three patients were eligible for analysis. Patients in the short-term storage group had similar baseline characteristics and received a similar amount of PRBC units compared with patients in the long-term storage group (five units (IQR, 3-10) vs. four units (2-8), p = 0.14). The mean storage age in the short-term storage group was 20 (±5.4) days compared with 32 (±3.1) days in the long-term storage group (mean difference 12 days (95%-CI, 11-13)). There was no difference in 28-day mortality between the short-term storage group compared with the long-term storage group (hazard ratio, 1.36 (95%-CI, 0.84-2.21), p = 0.21). While there were no differences in ventilator-free, sedation-free, and vasopressor-free days composites, patients in the long-term storage group compared with patients in the short-term storage group had a 75% lower chance for successful weaning from renal replacement therapy (RRT) within 28 days after ARDS onset (subdistribution hazard ratio, 0.24 (95%-CI, 0.1-0.55), p < 0.001). Further analysis indicated that even a single PRBC unit stored for more than 28 days decreased the chance for successful weaning from RRT. Prolonged storage of PRBCs was not associated with a higher mortality in adults with ARDS. However, transfusion of long-term stored PRBCs was associated with prolonged dependence of RRT in critically ill patients with an ARDS. |
| Keywords: | Transfusion, Red Blood Cells, ARDS |
| Source: | Journal of Clinical Medicine |
| ISSN: | 2077-0383 |
| Publisher: | MDPI |
| Volume: | 11 |
| Number: | 1 |
| Page Range: | 245 |
| Date: | 4 January 2022 |
| Official Publication: | https://doi.org/10.3390/jcm11010245 |
| PubMed: | View item in PubMed |
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