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Old red blood cells may double mortality in trauma patients

Submitted by on 19 October, 2018 – 4:32 am
Patients with severe trauma requiring major transfusion are twice as likely to die if they receive the red blood cells stored for one month or more, according to research published in the open access journal Critical Care BioMed Central. The highest rate of death was at the height of transfusion after six months which is consistent with previous reports in cardiac surgery patients.

Philip Spinella, Christopher Carroll, both pediatric intensivists Connecticut Children’s Medical Center in Hartford, Conn. and his team studied 202 patients with severe trauma treated at Hartford Hospital after a critical injury with five or more units of red cells. They found that even one unit of red cells stored 28 days more than doubled the incidence of deep vein thrombosis and death secondary to increased multiple organ failure.

Although medical experts had long suspected that the major complications caused red blood cell, this is one of the first studies that support this relationship drama. This study differs from previous studies because the number of units transfused red blood cell groups old and new RBC study were the same. As a result, this eliminated the main criticism of previous studies is the amount of transfused red blood cells not storage age was affecting the results.

More than 29 million units of blood were transfused in the United States in 2004, and this is a routine part and reliable treatment of trauma care worldwide. However, RBC transfusion is still associated with adverse complications. This study provides evidence that allows physicians to reduce these risks, allowing more fresh red blood cells to patients with severe trauma requiring transfusion of these important life-saving procedures.

According to Spinella, “The preferential use of younger RBCs critically ill patients has the potential to increase waste because of their age. Since blood is often a scarce resource, it is important and methods need to be developed to minimize waste while providing more effective blood product and safe for a particular patient.

The authors speculate, “These important findings should encourage research on the effects of old blood coagulation in critically ill patients. With the widespread use of red cell transfusion in critically injured patients, this study has the potential to reduce deaths in hospitals around the world. ”

More information: Duration of storage of red cells is associated with increased incidence of deep vein thrombosis and hospital mortality in patients with traumatic injuries, Philip C Spinella, Christopher Carroll L, Ilene Staff, Ronald Gross, Jacqueline Mc Quay, Lauren Keibel, Charles E Wade, John B Holcomb, Critical Care (in press); http://ccforum.com/

Source: BioMed Central (web)

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