Age of Red Cells for Transfusion and Outcomes in Patients with ARDS

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 (AR...

Full description

Bibliographic Details
Main Authors: Jan A. Graw, Victoria Bünger, Lorenz A. Materne, Alexander Krannich, Felix Balzer, Roland C. E. Francis, Axel Pruß, Claudia D. Spies, Wolfgang M. Kuebler, Steffen Weber-Carstens, Mario Menk, Oliver Hunsicker
Format: Article
Language:English
Published: MDPI AG 2022-01-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/11/1/245
_version_ 1797498626556035072
author Jan A. Graw
Victoria Bünger
Lorenz A. Materne
Alexander Krannich
Felix Balzer
Roland C. E. Francis
Axel Pruß
Claudia D. Spies
Wolfgang M. Kuebler
Steffen Weber-Carstens
Mario Menk
Oliver Hunsicker
author_facet Jan A. Graw
Victoria Bünger
Lorenz A. Materne
Alexander Krannich
Felix Balzer
Roland C. E. Francis
Axel Pruß
Claudia D. Spies
Wolfgang M. Kuebler
Steffen Weber-Carstens
Mario Menk
Oliver Hunsicker
author_sort Jan A. Graw
collection DOAJ
description 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), <i>p =</i> 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), <i>p =</i> 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), <i>p <</i> 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.
first_indexed 2024-03-10T03:36:02Z
format Article
id doaj.art-c3f3919f1c45431daa2a63f909c59845
institution Directory Open Access Journal
issn 2077-0383
language English
last_indexed 2024-03-10T03:36:02Z
publishDate 2022-01-01
publisher MDPI AG
record_format Article
series Journal of Clinical Medicine
spelling doaj.art-c3f3919f1c45431daa2a63f909c598452023-11-23T11:45:56ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111124510.3390/jcm11010245Age of Red Cells for Transfusion and Outcomes in Patients with ARDSJan A. Graw0Victoria Bünger1Lorenz A. Materne2Alexander Krannich3Felix Balzer4Roland C. E. Francis5Axel Pruß6Claudia D. Spies7Wolfgang M. Kuebler8Steffen Weber-Carstens9Mario Menk10Oliver Hunsicker11Department of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyExperimental and Clinical Research Center (ECRC), Charité-Universitätsmedizin Berlin, 10117 Berlin, GermanyInstitute of Medical Informatics, Charité-Universitätsmedizin Berlin, 10115 Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyInstitute of Transfusion Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyInstitute of Physiology, Charité-Universitätsmedizin Berlin, 10117 Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyPacked 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), <i>p =</i> 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), <i>p =</i> 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), <i>p <</i> 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.https://www.mdpi.com/2077-0383/11/1/245transfusionred blood cellsARDS
spellingShingle Jan A. Graw
Victoria Bünger
Lorenz A. Materne
Alexander Krannich
Felix Balzer
Roland C. E. Francis
Axel Pruß
Claudia D. Spies
Wolfgang M. Kuebler
Steffen Weber-Carstens
Mario Menk
Oliver Hunsicker
Age of Red Cells for Transfusion and Outcomes in Patients with ARDS
Journal of Clinical Medicine
transfusion
red blood cells
ARDS
title Age of Red Cells for Transfusion and Outcomes in Patients with ARDS
title_full Age of Red Cells for Transfusion and Outcomes in Patients with ARDS
title_fullStr Age of Red Cells for Transfusion and Outcomes in Patients with ARDS
title_full_unstemmed Age of Red Cells for Transfusion and Outcomes in Patients with ARDS
title_short Age of Red Cells for Transfusion and Outcomes in Patients with ARDS
title_sort age of red cells for transfusion and outcomes in patients with ards
topic transfusion
red blood cells
ARDS
url https://www.mdpi.com/2077-0383/11/1/245
work_keys_str_mv AT janagraw ageofredcellsfortransfusionandoutcomesinpatientswithards
AT victoriabunger ageofredcellsfortransfusionandoutcomesinpatientswithards
AT lorenzamaterne ageofredcellsfortransfusionandoutcomesinpatientswithards
AT alexanderkrannich ageofredcellsfortransfusionandoutcomesinpatientswithards
AT felixbalzer ageofredcellsfortransfusionandoutcomesinpatientswithards
AT rolandcefrancis ageofredcellsfortransfusionandoutcomesinpatientswithards
AT axelpruß ageofredcellsfortransfusionandoutcomesinpatientswithards
AT claudiadspies ageofredcellsfortransfusionandoutcomesinpatientswithards
AT wolfgangmkuebler ageofredcellsfortransfusionandoutcomesinpatientswithards
AT steffenwebercarstens ageofredcellsfortransfusionandoutcomesinpatientswithards
AT mariomenk ageofredcellsfortransfusionandoutcomesinpatientswithards
AT oliverhunsicker ageofredcellsfortransfusionandoutcomesinpatientswithards