Age of transfused blood is an independent risk factor for postinjury multiple organ failure

Zallen, Garret; Offner, Patrick J.; Moore, Ernest E.; Blackwell, John; Ciesla, David J.; Gabriel, Julie; Denny, Chris; Silliman, Christopher C.

doi:10.1016/s0002-9610(99)00239-1

Cited by 488 publications

(424 citation statements)

References 8 publications

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“…[12][13][14][15][16][17][18][19][20][21][22][23][24] Our study is unique in that it also indicates that even for patients with traumatic injuries who do not receive a massive transfusion the amount of RBCs transfused is independently associated with decreased survival. Previous and appropriate criticism of many of these studies has been that the amount of RBCs transfused is an indicator of severity of injury that cannot be completely adjusted for by regression analysis.…”

Section: Discussionmentioning

confidence: 75%

“…12,17,20,23,24 More importantly in animal and human studies of patients in shock, microvascular perfusion and oxygen consumption remains the same or decreases with RBC transfusion. 8,17,[25][26][27]59 The importance of the effect of RBC storage age on outcomes in critically ill patients is highlighted by the fact that the average age of transfused RBCs in the United States is 22 days 60 and multiple studies have indicated that the age of RBCs transfused is associated with increased morbidity and mortality in the critically ill. 18,22,61 The independent association of the amount of RBC transfusions with decreased survival may be related to the increased storage age of RBCs transfused to all patients in our study (33 days). The mean storage age of RBCs transfused per patient was not able to be analyzed as a variable associated with survival since this data were not recorded per patient.…”

Section: Discussionmentioning

confidence: 75%

See 1 more Smart Citation

Effect of Plasma and Red Blood Cell Transfusions on Survival in Patients With Combat Related Traumatic Injuries

Spinella

Perkins

Grathwohl

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

157

108

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 75%

Effect of Plasma and Red Blood Cell Transfusions on Survival in Patients With Combat Related Traumatic Injuries

Spinella

Perkins

Grathwohl

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

157

108

View full text Add to dashboard Cite

“…The second theory is that neutrophils are activated by biologically active lipids such as lysophosphatidylcholines that are released from cell membranes as stored blood products break down over time. 150,153 In support of this hypothesis, several studies have suggested that blood products that are stored longer may be more likely to produce TRALI in at-risk groups such as trauma 154 and severe sepsis patients. 155 …”

Section: Alcohol Abusementioning

confidence: 95%

Pathophysiology of Acute Lung Injury and the Acute Respiratory Distress Syndrome

Ware¹

2006

Semin Respir Crit Care Med

423

318

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Since the adult respiratory distress syndrome was first described substantial progress has been made in understanding the pathogenesis of this complex syndrome. This review summarizes our current understanding of the pathophysiology of what is now termed the acute respiratory distress syndrome (ARDS) and its less severe form acute lung injury (ALI), with an emphasis on cellular and molecular mechanisms of injury that may represent potential therapeutic targets. Although it is difficult to synthesize all of these abnormalities into a single, unified, pathogenetic pathway, a theme that emerges repeatedly is that of imbalance, be it between pro-and anti-inflammatory cytokines, oxidants and antioxidants, procoagulants and anticoagulants, neutrophil recruitment and activation and mechanisms of neutrophil clearance, or proteases and protease inhibitors. Future therapies aimed at restoring the overall balance of cytokines, oxidants, coagulants, and proteases may ultimately be successful where therapies that target individual cytokines or other mediators have not.

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“…Two years later, Zallen and his colleagues reported on a cohort retrospectively identified from a trauma centre registry on the basis of having received 6-20 units of red blood cells in the first 12 h after admission and consisting of 63 individuals, 23 of whom developed multiple organ failure [42]. The patients who developed multiple organ failure were older, 46 ± 4·7 vs. 33 ± 2·3 years, but also received red blood cells that had been stored longer, 30·5 ± 1·5 vs. 24 ± 0·5 days on average.…”

Section: Data From Clinical Studiesmentioning

confidence: 99%

Current issues relating to the transfusion of stored red blood cells

Zimrin¹,

2009

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The development of blood storage systems allowed donation and transfusion to be separated in time and space. This separation has permitted the regionalization of donor services with subsequent economies of scale and improvements in the quality and availability of blood products. However, the availability of storage raises the question of how long blood products can and should be stored and how long they are safe and effective. The efficacy of red blood cells was originally measured as the increment in haematocrit and safety began with typing and the effort to reduce the risk of bacterial contamination. Appreciation of a growing list of storage lesions of red blood cells has developed with our increasing understanding of red blood cell physiology and our experience with red blood cell transfusion. However, other than frank haemolysis, rare episodes of bacterial contamination and overgrowth, the reduction of oxygen-carrying capacity associated with the failure of some transfused cells to circulate, and the toxicity of lysophospholipids released from membrane breakdown, storage-induced lesions have not had obvious correlations with safety or efficacy. The safety of red blood cell storage has also been approached in retrospective epidemiologic studies of transfused patients, but the results are frequently biased by the fact that sicker patients are transfused more often and blood banks do not issue blood products in a random order. Several large prospective studies of the safety of stored red blood cells are planned.

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Age of transfused blood is an independent risk factor for postinjury multiple organ failure

Cited by 488 publications

References 8 publications

Effect of Plasma and Red Blood Cell Transfusions on Survival in Patients With Combat Related Traumatic Injuries

Effect of Plasma and Red Blood Cell Transfusions on Survival in Patients With Combat Related Traumatic Injuries

Pathophysiology of Acute Lung Injury and the Acute Respiratory Distress Syndrome

Current issues relating to the transfusion of stored red blood cells

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