Effects of Red-Cell Storage Duration on Patients Undergoing Cardiac Surgery

• Published in: The New England journal of medicine Vol. 372; no. 15; pp. 1419 - 1429
• Main Authors: Steiner, Marie E, Ness, Paul M, Assmann, Susan F, Triulzi, Darrell J, Sloan, Steven R, Delaney, Meghan, Granger, Suzanne, Bennett-Guerrero, Elliott, Blajchman, Morris A, Scavo, Vincent, Carson, Jeffrey L, Levy, Jerrold H, Whitman, Glenn, D’Andrea, Pamela, Pulkrabek, Shelley, Ortel, Thomas L, Bornikova, Larissa, Raife, Thomas, Puca, Kathleen E, Kaufman, Richard M, Nuttall, Gregory A, Young, Pampee P, Youssef, Samuel, Engelman, Richard, Greilich, Philip E, Miles, Ronald, Josephson, Cassandra D, Bracey, Arthur, Cooke, Rhonda, McCullough, Jeffrey, Hunsaker, Robert, Uhl, Lynne, McFarland, Janice G, Park, Yara, Cushing, Melissa M, Klodell, Charles T, Karanam, Ravindra, Roberts, Pamela R, Dyke, Cornelius, Hod, Eldad A, Stowell, Christopher P
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 09.04.2015
• Subjects: Adult; Age; Aged; Birth weight; Blood; Blood Grouping and Crossmatching; Blood Preservation; Blood transfusions; Cardiac Surgical Procedures; Clinical outcomes; Clinical trials; Erythrocyte Transfusion - adverse effects; Erythrocytes; Female; Heart; Heart surgery; Humans; Hyperbilirubinemia; Intensive care; Intention to Treat Analysis; Length of Stay; Male; Medical research; Middle Aged; Mortality; Multiple Organ Failure - classification; Patients; Proportional Hazards Models; Severity of Illness Index; Time Factors; United States > US
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1414219

In a trial involving nearly 1100 patients undergoing cardiac surgery, there were no significant differences in outcomes among patients receiving transfusions of red cells stored for 10 days or less as compared with outcomes in those receiving red cells stored for 21 days or more. The objective of red-cell transfusion is to increase oxygen delivery and improve clinical outcomes. However, in the United States, storage systems are licensed for up to 42 days on the basis of the estimated in vivo recovery of transfused red cells rather than on the basis of the clinical effectiveness of the transfusion. 1 During storage, red cells undergo numerous changes. 2 , 3 Some laboratory data suggest that red cells stored for longer periods may not traverse the microcirculation or deliver oxygen as effectively as those stored for shorter periods. 4 , 5 Several observational studies have assessed the association between the duration of . . .