Table 3 Studies reporting no clinical effect of prolonged RBC storage
From: Age of red blood cells and transfusion in critically ill patients
Author | Year | Setting | N | Study design | Adjustment for confounders | Leukodepletion | Outcome and main results |
|---|---|---|---|---|---|---|---|
Wasser et al.[47] | 1989 | Post- CABG | 237 | Single-center randomized Cases: RBC<12 hours; controls: RBC stored for 2 to 5 days | NA | No | No difference in bleeding and RBC transfusion requirement, nonetheless the platelets counts and thrombotest were significantly less altered in the study arm |
Schulman et al.[48] | 2002 | Trauma, ≥2 RBC units | 17 | Single-center randomized pilot study “Fresh group”: RBC<11 days; “Old group”: RBC >20 days | NA | Yes | Mortality, infectious complications, respiratory failure |
Vamvakas et al.[49] | 2000 | Post- CABG | 268 | Retrospective single-center | Gender, patient age, comorbidities, type of CABG, IABP, duration of anaesthesia, time on bypass, other surgery, repeated surgery, chest tube drainage volume | No | Post-operative ICU LOS, hospital LOS and MV duration |
Gajic et al.[50] | 2004 | ICU patients with MV | 181 | Retrospective single-center | APACHE III score, Tidal volume, thrombocytopenia, massive transfusion | 70% | Median storage duration of the oldest RBC unit = 20.3 days (range: 16–31) in absence of ALI versus 20.1 days (range: 16–27) in presence of ALI |
Hebert et al.[51] | 2005 | ICU | 57 | Double-blind multicenter, randomized pilot study | Comorbidities, major diagnostic grouping, center | Yes | Composite outcome (mortality, nosocomial infections, thrombotic events, ischemic stroke) |
Van de Watering et al.[52] | 2006 | Post- CABG RBC given during surgery and for 3 days post-surgery | 2732 | Retrospective single-center study Cases: RBC <18 days Controls: standard cares | Year of surgery, volume of transfusion, duration of surgery, previous CABG, number of distal anastomoses, patient age, gender, Hb at admission | No | 30-day survival, hospital and ICU LOS |
Taylor et al.[53] | 2006 | ICU | 449 | Prospective single-center observational | Patient age, survival probability | Mixed | Nosocomial infection, mortality, ICU and hospital LOS |
Gajic et al.[54] | 2007 | ICU with ALI | 74 | Prospective single-center case–control study | Patients characteristic, transfusion factors | NG | Patients with ALI (median of average RBC storage = 22.9 days (range: 17–31) versus 22.9 days (range: 15–30) in controls (p = 0.801) |
Yap et al.[55] | 2008 | Post-CABG and valve surgery, ≥2 RBC units | 670 | Retrospective single-center | Pre-operative risk profile, volume of RBC | <5% | Mortality, renal failure, nosocomial pneumonia, ICU LOS, MV duration |
Van Buskirk et al.[56] | 2010 | ICU | 298 | Retrospective single-center | Volume of RBC, patient age, gender, severity at ICU admission, admission diagnosis | NG | Transfusion complications, change in SOFA score, ICU LOS, mortality |
Katsios et al.[57] | 2011 | ICU | 126 | Prospective single-center observational | History of previous DVT, chronic dialysis, platelets transfusion, requirement of vasopressors | No | DVT |
*Mckenny et al.[58] | 2011 | Post-cardiac surgery | 1153 | Retrospective single-center | Volume of RBC, baseline and patient characteristics | Yes | Early post-operative mortality, post-operative MV >72h, renal failure, infections, 30 day mortality, hospital mortality, prolonged MV, new renal failure, infectious complications and ICU LOS |
Van Straten et al.[59] | 2011 | Post-CABG, ≤10 RBC units | 3475 | Retrospective single-center | Patient age, comorbidities, redo cardiac surgery, pre-operative Hb, emergency operation, perioperative MI, Re-exploration, year of operation, volume of RBC, FFP and platelets | Yes | Mortality |
Kor et al.[62] | 2012 | ICU patients with MV | 100 | Double-blind randomized single-center Cases: one fresh RBC unit (<5 days) Control: one RBC unit of standard practices | NA | Yes | Change in PaO2/FiO2 ratio, in peak and plateau airway pressures, in markers of immune status and in coagulation |