Information de reference pour ce titreAccession Number: | 00007885-202009000-00011.
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Author: | Mack, Johnathan 1; Kahn, Susan R. 2; Tinmouth, Alan 1; Fergusson, Dean 3; Hebert, Paul C. 4; Lacroix, Jacques 5; The Canadian Critical Care Trials Group
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Institution: | (1) Department of Medicine, Ottawa General Hospital, University of Ottawa, Ottawa Ontario, Canada, (2) Department of Medicine and Lady Davis Institute, Jewish General Hospital, McGill University, Montreal Quebec, Canada, (3) Ottawa Hospital Research Institute, University of Ottawa, Ottawa Ontario, Canada, (4) Division of Critical Care, Centre Hospitalier Universitaire de Montreal, Universite de Montreal, Montreal Quebec, Canada, (5) Division of Pediatric Critical Care Medicine, Centre Hospitalier Universitaire Sainte-Justine, Universite de Montreal, Montreal Quebec, Canada,
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Title: | |
Source: | Transfusion. 60(9):1929-1939, September 2020.
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Abstract: | Background: An increased risk of complications, including death, has been associated with stored red blood cell (RBC) units in observational studies but not in randomized trials. We aimed to evaluate for volume-dependent effects attributable to length of RBC storage in a secondary analysis of the Age of Blood Evaluation (ABLE) trial.
Study Design and Methods: In the 2510 critically ill adults from the ABLE trial randomized to receive RBC units stored not more than 7 days or the oldest compatible RBC units, we estimated the hazard ratio (HR) for death by intensive care unit (ICU) and hospital discharge and by days 28, 90, and 180, within subgroups defined by the number of RBC units received. Extended Cox proportional hazards regression was used to model the HR.
Results: A volume-dependent effect of storage age on survival was present for death by 90 and 180 days, but not earlier endpoints. The HR for death by 90 days was 0.55 (95% confidence interval [CI], 0.11-0.98, fresh vs standard) after transfusion of 6 RBC units but 1.45 (95% CI, 1.06-1.98) after transfusion of 1 RBC unit.
Conclusion: In this exploratory analysis, volume-dependent effects related to RBC storage were documented in the ABLE trial. The harms associated with small volumes of fresh RBC units and large volumes of older RBC units should be further explored.
(C) 2020 John Wiley & Sons, Ltd
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Author Keywords: | erythrocyte; intensive care; length of storage; transfusion.
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Language: | English.
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Document Type: | TRANSFUSION MEDICINE.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0041-1132
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NLM Journal Code: | wdn, 0417360
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DOI Number: | https://dx.doi.org/10.1111/trf.1...- ouverture dans une nouvelle fenêtre
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