The effect of fresh versus stored blood on post‐operative bleeding after coronary bypass surgery: a prospective randomized study

Wasser, M. N. J. M.; Houbiers, J. G. A.; DʼAmaro, J.; Hermans, J.; Huysmans, Hans A.; Kinijnenburg, G. C. van; Brand, Anneke

doi:10.1111/j.1365-2141.1989.tb07656.x

Cited by 49 publications

(37 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although close to a dozen RCTs have been published on the relationship between storage duration and adverse outcomes [115][116][117][118][119][120][121][122][123][124], the majority have been either small or not adequately powered to evaluate mortality. Moreover, none of them have found any significant differences in outcomes between fresh and old subgroups of transfusion recipients across a variety of clinical settings.…”

Section: Randomised Controlled Trials (Rct)mentioning

confidence: 99%

“…These have included healthy volunteers [67,[80][81][82], numerous retrospective and prospective observational studies [77,, and a handful of older [115][116][117][118][119][120][121][122][123], more recent [124], and ongoing randomised controlled trials. Overall, study results have been conflicting and affected by multiple methodological issues including confounding, systematic bias, limited external validity and multiple statistical shortcomings.…”

Section: Current State Of Clinical Evidence On the Clinical Relevancementioning

confidence: 99%

See 1 more Smart Citation

The pathophysiology and consequences of red blood cell storage

2014

View full text Add to dashboard Cite

Red cell transfusion therapy is a common treatment modality in contemporary medical practice. Although blood collection and administration is safer and more efficient than ever before, red cells undergo multiple metabolic and structural changes during storage that may compromise their functionality and viability following transfusion. The clinical relevance of these changes is a hotly debated topic that continues to be a matter of intense investigation. In the current review, we begin with an in-depth overview of the pathophysiological mechanisms underlying red cell storage, with a focus on altered metabolism, oxidative stress and red cell membrane damage. We proceed to review the current state of evidence on the clinical relevance and consequences of the red cell storage lesion, while discussing the strengths and limitations of clinical studies.

show abstract

Section: Randomised Controlled Trials (Rct)mentioning

confidence: 99%

Section: Current State Of Clinical Evidence On the Clinical Relevancementioning

confidence: 99%

The pathophysiology and consequences of red blood cell storage

2014

View full text Add to dashboard Cite

show abstract

“…30 The few randomized trials have been limited by small size 31 or restrictive transfusion criteria. 32 Recently, the large multicenter ARIPI trial 33 demonstrated that neonates randomized to transfusion of red cell units < 7 days old compared to usual practice experienced no difference in the composite outcome of major neonatal morbidity. Several large multicenter randomized trials are currently enrolling adult patients, including RECESS 28 (cardiac surgery patients; NCT00991341), Canadian ABLE 34 (ICU patients; ISRCTN44878718) and TRANSFUSE (critically ill patients in Australia and New Zealand; NCT01638416).…”

Section: Discussionmentioning

confidence: 99%

Length of Red Cell Unit Storage and Risk for Delirium After Cardiac Surgery

Brown

Grega

Selnes

et al. 2014

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

Background The time that red cell units are stored before transfusion may be associated with postoperative complications, although the evidence is conflicting. However, the association between the length of red cell unit storage and postoperative delirium has not been explored. We hypothesized that the length of storage of transfused red cell units would be associated with delirium after cardiac surgery. Methods We conducted a case-control study in which patients undergoing coronary artery bypass, valve, or ascending aorta surgery with cardiopulmonary bypass at Johns Hopkins from 2005–2011 were eligible for inclusion. Patients were excluded if they did not receive red cell units, received >4 red cell units during hospitalization, received any transfusion after the first postoperative day, or received red cell units that were not exclusively stored for ≤14 days or >14 days. Eighty-seven patients met transfusion-related inclusion criteria and developed postoperative delirium. Controls who did not develop delirium were selected from the same source population of eligible patients and were matched 1:1 based on age (+/− 5 years), 2-2.5-year band of date of surgery, and surgical procedure. For each patient, we calculated the average storage duration of all transfused red cell units. The primary outcome was odds of delirium in patients who were transfused red cell units with exclusive storage duration >14 days compared to ≤14 days. Secondary outcomes were odds of delirium with each increasing day of average red cell unit storage duration. We used conditional multivariable regression to test our hypotheses. Results In conditional multivariable analysis of 87 case-control pairs, there was no difference in the odds of patients developing delirium if they were transfused red cell units with an exclusive storage age >14 days compared to ≤14 days (odds ratio [OR] 1.83; 95% CI, 0.73–4.58, P=0.20). Each additional day of average red cell unit storage beyond 14 days was associated with a 1.01–1.13 fold increase in the odds of postoperative delirium (OR, 1.07; P=0.03). Each additional day of average storage beyond 21 days was associated with a 1.02–1.23 fold increase in the odds of postoperative delirium (OR, 1.12; P=0.02). Conclusion Transfusion of red cell units that have been stored for more than 14 days is not associated with increased odds of delirium. However, each additional day of storage more than 14 days or 21 days may be associated with increased odds of postoperative delirium in patients undergoing cardiac surgery. More research is needed to further characterize the association between delirium and storage duration of transfused red cell units.

show abstract