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• W2164544340 abstract "An increasing body of literature on the clinical consequences of the storage duration of red blood cells (RBCs) in various patient groups highlights the importance of this issue to clinicians and blood services. Lelubre and Vincent recently published a systematic review including 55 clinical studies on the effect of age of RBCs on various clinical outcomes. 1 This review, with others, 2,3 emphasises the heterogeneity in the methodology of studies. In addition, it supports equipoise concerning the clinical effects of RBC storage duration, and the need for large randomised controlled trials (RCTs). There is currently only one large published RCT that addresses the issue of the age of blood in 377 critically ill patients. The Age of Red Blood Cells in Premature Infant (ARIPI) RCT showed no difference in mortality combined with major neonatal morbidity in very low birthweight premature infants receiving fresher blood (< 7 days old) compared with standard practice. 4 The negative result provides evidence that a fresh blood transfusion is not associated with a better outcome in this patient group, but the same question in adults is not answered and there are no definitive trials in trauma patients. 4 Trauma patients and RBC storage duration The two-hit hypothesis, supported by animal models, suggests that pre-existing pathological changes associated with inflammation and oxidative stress enhance the adverse effects related to the RBC storage duration. 5-7 Critically ill patients are highly heterogeneous in terms of pathological processes and clinical states. In contrast, critically ill trauma patients are predominantly young, often free of comorbidities and victims of a well defined injury. Among the 18 studies evaluating the effects of the age of blood that have been conducted in trauma patients, 15 found a negative impact of older blood on patient outcomes, suggesting that this patient group may be particularly susceptible to the potential effect of RBC storage duration. 1 The large volume of blood that they receive in a short time and/or the systemic inflammatory response syndrome secondary to trauma may contribute to the potential association between age of blood and outcome. The two large RCTs which are currently being conducted" @default.
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• W2164544340 date "2013-09-01" @default.
• W2164544340 modified "2023-09-23" @default.
• W2164544340 title "Is an age-of-blood transfusion trial in trauma patients in Australia and New Zealand feasible?" @default.
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