Effect of Red Blood Cell Storage Duration on Outcome After Paediatric Cardiac Surgery: A Prospective Observational Study

Bishnoi, Arvind Kumar; Garg, Pankaj; Patel, Kartik; Chandrasekaran, A.; Shah, Rushikesh; Solanki, Atul; Pandya, Himani; Patel, Sanjay

doi:10.1016/j.hlc.2018.03.012

Cited by 8 publications

(14 citation statements)

References 25 publications

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“…However, the data in paediatric cardiac surgery are less clear, as there have only been a few retrospective studies published to date, with mixed results. Some have shown adverse effects when transfusing blood stored for a longer duration, [3][4][5][6] while others have shown no differences in clinical outcomes [7][8][9][10]. Many of these studies have been limited by small sample sizes, [6,10] and unclear methodology regarding how RBC storage duration was classified [7,10].…”

Section: Discussionmentioning

confidence: 99%

“…Some have shown adverse effects when transfusing blood stored for a longer duration, [3][4][5][6] while others have shown no differences in clinical outcomes [7][8][9][10]. Many of these studies have been limited by small sample sizes, [6,10] and unclear methodology regarding how RBC storage duration was classified [7,10]. While there are multiple ways to analyse RBC storage duration for patients who are transfused more than 1 RBC unit, such as categorizing patients based on the oldest RBC unit transfused, [6] or simply averaging the age of the RBC units, [3] each of these methodologies is associated with significant amounts of confounding.…”

Section: Discussionmentioning

confidence: 99%

“…While randomized controlled trials in adult cardiac surgery patients have demonstrated no association between RBC storage duration and postoperative outcomes, [2] the data among paediatric cardiac surgery patients are less robust. Much of the research in this patient population has been centred on small retrospective studies, with conflicting results [3][4][5][6][7][8][9][10]. Although some studies suggest poorer outcomes and more peri-operative complications when transfusing RBCs with a longer storage duration, [3][4][5][6] others have demonstrated no differences in clinical outcomes [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Much of the research in this patient population has been centred on small retrospective studies, with conflicting results [3][4][5][6][7][8][9][10]. Although some studies suggest poorer outcomes and more peri-operative complications when transfusing RBCs with a longer storage duration, [3][4][5][6] others have demonstrated no differences in clinical outcomes [7][8][9][10]. These studies, however, have been limited by small sample sizes and differing methodologies in terms of how to best analyse RBC storage duration for patients receiving more than 1 RBC unit [6,7,10].…”

Section: Introductionmentioning

confidence: 99%

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Red blood cell storage duration and peri‐operative outcomes in paediatric cardiac surgery

Padiyath

Ong

et al. 2021

Vox Sanguinis

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Background Prior research on red blood cell (RBC) storage duration and clinical outcomes in paediatric cardiac surgery has shown conflicting results. The purpose of this study was to evaluate whether blood stored for a longer duration is harmful in these patients. MethodsWe performed a retrospective cohort study of paediatric patients undergoing cardiac surgery at our institution between January 2011 and June 2015. Patients were stratified based on whether they were transfused RBCs stored for ≤15 days (fresher blood) or >15 days (older blood). The primary outcome was composite morbidity, with prolonged length of stay (LOS) as a secondary outcome. Subgroup analyses were performed after stratification by RBC transfusion volume (≤2 vs. >2 RBC units). Multivariable logistic regression models were used to assess the impact of RBC storage duration on composite morbidity and prolonged LOS.Results Of 461 patients, 122 (26Á5%) received fresher blood and 339 (73Á5%) received older blood. The overall rate of composite morbidity was 18Á0% (n = 22) for patients receiving fresher blood and 13Á6% (n = 46) for patients receiving older blood (P = 0Á24). In the risk-adjusted model, patients receiving older blood did not exhibit an increased risk of composite morbidity (OR: 0Á74, 95% CI: 0Á37-1Á47, P = 0Á40) or prolonged LOS (OR: 0Á72, 95% CI: 0Á38-1Á35, P = 0Á30) compared to patients receiving fresher blood. Similar results were seen after stratification by RBC transfusion volume.Conclusions Transfusing RBCs stored for a longer duration was not associated with an increased risk of morbidity or prolonged LOS in paediatric cardiac surgery patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Red blood cell storage duration and peri‐operative outcomes in paediatric cardiac surgery

Padiyath

Ong

et al. 2021

Vox Sanguinis

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“…In addition, patients who received RBCs stored for 21 days or more also received significantly greater volumes of RBCs, indicating possible confounding within this population. Other prospective studies, which randomized patients to receive transfusions of specified storage ages, have failed to replicate the association with poor outcomes . Two recent meta‐analyses failed to show a decrease in patient mortality when fresh RBCs were used, as compared to blood of a standard age .…”

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confidence: 99%

The use of rejuvenated red blood cells for transfusion in patients with sickle cell anemia

Webb

2019

Transfusion

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RBC Inventory-Management System Based on XGBoost Model

Sun

Xu²,

Feng

et al. 2020

Indian J Hematol Blood Transfus

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It is difficult to predict RBC consumption accurately. This paper aims to use big data to establish a XGBoost Model to understand the trend of RBC accurately, and forecast the demand in time. XGBoost, which implements machine learning algorithms under the Gradient Boosting framework can provide a parallel tree boosting. The daily RBC usage and inventory (May 2014-September 2017) were investigated, and rules for RBC usage were analysed. All data were divided into training sets and testing sets. A XGBoost Model was established to predict the future RBC demand for durations ranging from a day to a week. In addition, the alert range was added to the predicted value to ensure RBC demand of emergency patients and surgical accidents. The gap between RBC usage and inventory was fluctuant, and had no obvious rule. The maximum residual inventory of a certain blood group was up to 700 units one day, while the minimum was nearly 0 units. Upon comparing MAE (mean absolute error):A:10.69, B:11.19, O:10.93, and AB:5.91, respectively, the XGBoost Model was found to have a predictive advantage over other state-of-the-art approaches. It showed the model could fit the trend of daily RBC usage. An alert range could manage the demand of emergency patients or surgical accidents. The model had been built to predict RBC demand, and the alert range of RBC inventory is designed to increase the safety of inventory management.

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Effect of Red Blood Cell Storage Duration on Outcome After Paediatric Cardiac Surgery: A Prospective Observational Study

Cited by 8 publications

References 25 publications

Red blood cell storage duration and peri‐operative outcomes in paediatric cardiac surgery

Red blood cell storage duration and peri‐operative outcomes in paediatric cardiac surgery

The use of rejuvenated red blood cells for transfusion in patients with sickle cell anemia

RBC Inventory-Management System Based on XGBoost Model

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