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Age of red cells for transfusion and outcomes in critically ill adults

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, the Department of Intensive Care, Alfred Hospital, the Department of Haematology, Monash Health, the Department of Intensive Care, Austin Hospital, the University of Melbourne, Research and Development, Australian Red Cross Blood Service, and the Department of Intensive Care, Western Health - all in Melbourne, VIC, Australia; Irish Critical Care Clinical Trials Network, University College Dublin Clinical Research Centre at St. Vincent's University Hospital, Dublin; the Departement de Medecine Intensive Reanimation, Brest University Hospital, Brest, France; the Department of Anesthesiology and the Division of Intensive Care, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki; and the Medical Research Institute of New Zealand and the Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand

The New England Journal of Medicine. 2017;377((19):):1858-1867
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Abstract
Background It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults. Methods In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality. Results From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5%) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8%) in the short-term storage group and 594 (24.1%) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.7 to 3.1; P=0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95% CI, -2.1 to 3.0; P=0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome. Conclusions The age of transfused red cells did not affect 90-day mortality among critically ill adults. (Funded by the Australian National Health and Medical Research Council and others; TRANSFUSE Australian and New Zealand Clinical Trials Registry number, ACTRN12612000453886 ; ClinicalTrials.gov number, NCT01638416 .).
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Language : English
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine