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...
Main Authors: | , , , , , , , , , , , |
---|---|
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 |