title: A pilot trial evaluating the clinical effects of prolonged storage of red cells.
abstract: The clinical consequences of prolonged storage of red cells have not been established. In this pilot study, we evaluated whether it would be feasible to provide a continuous supply of red cells stored <8 days. In addition, we examined the potential benefits attributed to "fresh" as compared to standard red cells in 66 critically ill and cardiac surgical patients. Nine patients were issued red cells but were not transfused. From the 57 remaining patients, the number of units transfused averaged 5.5 +/- 8.43 red cell units in the experimental group compared to 3.3 +/- 3.27 red cell units in the standard group (P = 0.25). The median storage time was 4 days in the experimental group compared to 19 days in the standard group (difference of 15 days; interquartile range of 12-16 days; P < 0.001). Overall, 73% of patients received red cells with storage times that corresponded to the treatment allocation more than 90% of the time. The group receiving red cells <8 days old tended to be older on average (68 +/- 8.54 yr versus 63 +/- 15.30 yr; P = 0.13) and have more comorbid illnesses (85% versus 65%; P = 0.09). In total, 27% of patients in the experimental group died or had a life-threatening complication as compared to 13% in the standard group (P = 0.31). There were no differences in prolonged respiratory, cardiovascular, or renal support after randomization (P > 0.05). A large clinical trial comparing red cell storage times is feasible and warranted given the limited available evidence.
authors.affiliation: *University of Ottawa Centre for Transfusion Research, Ottawa Hospital Research Institute, Clinical Epidemiology Unit; †Division of Hematology, London Health Sciences Centre, Ontario; ‡Department of Laboratory Medicine, McMaster University Health Centre; §Division of Cardiovascular Anaesthesiology, Institut de Cardiologie de Montreal; and ∥Department of Pathology, Ottawa Hospital, Canada.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Hébert
authors.forename: Ian
authors.initials: I
authors.lastname: Chin-Yee
authors.forename: Dean
authors.initials: D
authors.lastname: Fergusson
authors.forename: Morris
authors.initials: M
authors.lastname: Blajchman
authors.forename: Raymond
authors.initials: R
authors.lastname: Martineau
authors.forename: Jennifer
authors.initials: J
authors.lastname: Clinch
authors.forename: Bernhard
authors.initials: B
authors.lastname: Olberg
mesh_terms: D000328:Adult; D000368:Aged; D001771:Blood Banks; D001793:Blood Preservation; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013997:Time Factors