Persistence of Elevated Plasma CXCL8 Concentrations Following Red Blood Cell Transfusion in a Trauma Cohort

Abstract

Red blood cell (RBC) transfusion is associated with alterations in systemic concentrations of IL-8/CXCL8 functional homologues in a murine model. Whether RBC transfusion alters systemic neutrophil chemokine concentrations in individuals sustaining traumatic injury is not known. We conducted a retrospective, single-center study of severely injured trauma patients presenting within 12 h of injury with a base deficit > 6 and hypotension in the field. Plasma concentrations of twenty-five chemokines, cytokines, and growth factors were obtained from both transfused (N=22) and non-transfused (N=33) groups in the first 48 h following admission. The transfused group (mean RBC units ± SD: 2.7 ±1.7) tended to be older (49.9 ±21.1 versus 40.4 ±19.9 years, p=0.10), with a higher percentage of females (40.9% versus 18.2%, p=0.06), and a higher injury severity score (ISS) (27.1 ±12.7 versus 21.4 ±10.2, p=0.07). In univariate and multivariate analyses, transfusion was associated with increased hospital and ICU length of stay but not ventilator-free days. Plasma CXCL8 concentrations were higher in the transfused (mean ±SD: 84 ±88 pg/mL) than the non-transfused group (31 ±21 pg/mL, p=0.003). Using a linear prediction model to calculate bioanalyte concentrations standardized for age, gender, ISS, and admission SBP, we observed that CXCL8 concentrations diverged within 12 hours following injury, with the transfused group showing persistently elevated CXCL8 concentrations by contrast to the decay observed in the non-transfused group. Other bioanalytes showed no differences across time. RBC transfusion is associated with persistently elevated neutrophil chemokine CXCL8 concentrations following traumatic injury.

Monocyte Count in Preterm Neonates With and Without Necrotizing Enterocolitis

“…8 Monocytosis may occur more often than monocytopenia and can occur in combination with extreme prematurity, repeated transfusions of red blood cells, albumin, and theophylline. 21 In syphilis and congenital candidiasis, 22,23 as well as in immune-mediated neutropenia, monocytosis may also occur. 24,25 This study has some limitations.…”

Acute drop in blood monocyte count differentiates NEC from other causes of feeding intolerance

“… 35 In the NICU, monocytosis may be seen more frequently than monocytopenia and may occur in association with extreme prematurity, repeated RBC transfusions, albumin infusions, and theophylline therapy. 36 Monocytosis can also be seen in congenital candidiasis and syphilis, 37 , 38 and in immune-mediated neutropenia. 39 , 40 …”

Leukoreduced blood transfusion does not increase circulating soluble markers of inflammation: a randomized controlled trial

“…Several previous studies have found nonleukoreduced blood to have proinflammatory effects. 12,27,28 These studies were undertaken in the context of volume resuscitation or in patients undergoing cardiac and orthopedic surgery rather than in a mixed hemodynamically stable critical care population. 29,30 Importantly, these were nonrandomized cohort studies subject to confounding, especially bias by indication.…”