Transfusing red blood cells stored in citrate phosphate dextrose adenine-1 for 28 days fails to improve tissue oxygenation in rats

Abstract

Storage of rat red blood cells for 28 days in citrate phosphate dextrose adenine-1 impaired their ability to improve tissue oxygenation when transfused into either control or septic rats placed into supply dependency of systemic VO2.

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

“…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.…”

Hemoglobin-driven pathophysiology is an in vivo consequence of the red blood cell storage lesion that can be attenuated in guinea pigs by haptoglobin therapy

“…Reduced rbc deformability with storage time correlated with decreased rbc survival in vivo (5) and may be accompanied by enhanced lysis of donor rbc with intravascular hemolysis after transfusion. Normal and disease state rodent models have suggested that transfusion of older blood increases senescent rbc clearance (6), iron-induced inflammation (7,8), and tissue oxygen debt due to microcirculatory derangement (9), potentially caused by microcirculatory rbc trapping (10).…”

Blood Tranfusion in Critically Ill Patients: State of the Art

“…Other studies have failed to demonstrate benefits of transfusion in septic patients. [91][92][93][94][95] Considering the evidence from above cited studies, septic patients do not benefit from a higher hemoglobin level. The benefits of transfusion are questionable, and the risks are known in this population.…”

“…Initially, by day 5 to 10, red cells get spicules on the surface of their membranes. 100 These spicules fall off, and the cells become rounded (spherocytes) but also swell and lose their flexibility. They lose approximately 15% to 20% of their cell membrane phospholipids by day 15 to 28.…”

“…They lose approximately 15% to 20% of their cell membrane phospholipids by day 15 to 28. 100 As the red cells survive in their anoxic environment, they lose their Na-K ATPase function, and become edematous. With cell swelling and loss of lipid membrane material, red cells become very stiff and quite friable.…”