title: The effects of non-leukoreduced red blood cell transfusions on microcirculation in mixed surgical patients.
abstract: BACKGROUND
  The impact of the storage process on oxygen-carrying properties of red blood cells and the efficacy of red blood cell (RBC) transfusions concerning tissue oxygenation remain an issue of debate in transfusion medicine. Storage time and leukocyte content probably interact since longer storage duration is thought to cause greater accumulation of leukocyte-derived cytokines and red blood cell injury.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effects of storage and the efficacy of fresh (stored for less than 1 week) versus aged (stored for more than 3 weeks) non-leukoreduced RBC transfusions on sublingual microvascular density and flow in mixed surgical patients.
  
  
  METHODS
  Eighteen surgical patients were included in this study. Patients were randomly assigned into two groups receiving fresh (Group A) and aged (Group B) RBC transfusions. Sublingual microcirculatory functional capillary density (FCD) and microvascular flow index (MFI) were assessed using orthogonal polarization spectral (OPS) imaging. Measurements and collection of blood samples were performed after induction of general anesthesia, before RBC transfusion and 30 min after the RBC transfusion ended.
  
  
  RESULTS
  In both groups RBC transfusions caused an increase in hemoglobin concentration (p<0.001). RBC transfusions increased FCD in Group A (p<0.001), while FCD remained unaffected in Group B. Changes in MFI following RBC transfusion in both groups remained unaltered.
  
  
  CONCLUSIONS
  Fresh non-leukoreduced RBC transfusions but not RBCs stored for more than 3weeks, were effective in improving microciruculatory perfusion by elevating the number of perfused microvessels in mixed surgical patients.
authors: Department of Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Anesthesiology and Reanimation, Hacettepe University, Faculty of Medicine, Ankara, Turkey. Electronic address: banu.ayhan@gmail.com.
authors: Banu
authors: B
authors: Ayhan
authors: Koray
authors: K
authors: Yuruk
authors: Sophia
authors: S
authors: Koene
authors: Altan
authors: A
authors: Sahin
authors: Can
authors: C
authors: Ince
authors: Ulku
authors: U
authors: Aypar
mesh_terms: D000328:Adult; D000368:Aged; D001793:Blood Preservation; D016207:Cytokines / Q000097:blood*; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D013514:Surgical Procedures, Operative; D013997:Time Factors
chemical_list: D016207:Cytokines
keywords: Blood transfusion; Microcirculation; OPS imaging; RBC storage; Surgery