Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults
D James Cooper, Zoe K McQuilten, Alistair Nichol, Bridget Ady, Cécile Aubron, Michael Bailey, Rinaldo Bellomo, Dashiell Gantner, David O Irving, Kirsi-Maija Kaukonen, Colin McArthur, Lynne Murray, Ville Pettilä, Craig French, TRANSFUSE Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group, P Mondy, N Orford, J Presneill, M Reade, A Webb, S Vallance, C Mashonganyika, C Maher, J Board, P McCracken, M Young, S McGuinness, E Gilder, K Cowdrey, L McCarthy, R Parke, K Benefield, R McConnochie, G Eastwood, H Young, L Peck, R Dwyer, M Large, J Fletcher, J Smith, D Ghelani, K Nand, T Sara, A Rashid, I Bailey, G Ding, K Smith, J Barrett, V Sarode, G Hanlon, F Van Haren, H Rodgers, S Noble, S Henderson, J Mehrtens, P Seigne, E Neau, V Sanjiv, K Shepherd, E Blasquez, D France, R Hutchinson, I Carney, C Green, C Allen, A M Palermo, M Scully, C Cattigan, A Bone, B Richards, M Tallot, R Cameron, K Ellis, K Salmela, S Sutinen, J Brieva, M Hardie, S A Solamy, N A Assmi, S Bernard, C Serban, H White, J Sutton, C Motherwell, P Thomas, N Soar, A Kazemi, A Tilsey, K Gregory, D Ernest, P Galt, B King, F Simmons, L Cole, L Weisbrodt, J Liang, D Hacking, J Bell, A Ghosh, S Said, Y Shehabi, N Straiton, P Kruger, E Venz, E Saylor, J Meyer, K Wetzig, S Peake, C Kurendra, P Williams, D Evans, S Kloeden, S O’Connor, J Butler, P Jarrett, D Cooper, R McAllister, C MacIsaac, A Jordan, T Bowles, E Jenkinson, D Gattas, D Hutch, H Buhr, K Deshpande, D Inskip, J Miller, T Ryan, E O'Toole, A Regli, A Palermo, J Santamaria, J Holmes, M Nicolls, C Reynolds, K McCann, S Leow, A Westbrook, E Meaney, K Brickell, S Bates, A Kuitunen, A Kukkurainen, S Varila, P May, B Stehr, A Forrest, J Barlow-Armstrong, B Ure, S Hurford, R Sol Cruz, M Sterba, B Johnson, P Diaz, S Mattos, S Sirigireddy, G Shuttleworth, P Flanagan, C Smith, D Medley, W Murphy, B Quirke, M Barry, E Kerkelä, T Krusius, J Nikkilä, M Syrjälä, K Al Khairy, F Alsaqri, H Al Wasel, E Osman, M Galligan, G Guyatt, C Brun-Buisson, N Heddle, S Walter, A Higgins, V Singh, P Doran, P Murray, C Fahey, L Burke, J Laffey, D McAuley, J Fitzgerald, D James Cooper, Zoe K McQuilten, Alistair Nichol, Bridget Ady, Cécile Aubron, Michael Bailey, Rinaldo Bellomo, Dashiell Gantner, David O Irving, Kirsi-Maija Kaukonen, Colin McArthur, Lynne Murray, Ville Pettilä, Craig French, TRANSFUSE Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group, P Mondy, N Orford, J Presneill, M Reade, A Webb, S Vallance, C Mashonganyika, C Maher, J Board, P McCracken, M Young, S McGuinness, E Gilder, K Cowdrey, L McCarthy, R Parke, K Benefield, R McConnochie, G Eastwood, H Young, L Peck, R Dwyer, M Large, J Fletcher, J Smith, D Ghelani, K Nand, T Sara, A Rashid, I Bailey, G Ding, K Smith, J Barrett, V Sarode, G Hanlon, F Van Haren, H Rodgers, S Noble, S Henderson, J Mehrtens, P Seigne, E Neau, V Sanjiv, K Shepherd, E Blasquez, D France, R Hutchinson, I Carney, C Green, C Allen, A M Palermo, M Scully, C Cattigan, A Bone, B Richards, M Tallot, R Cameron, K Ellis, K Salmela, S Sutinen, J Brieva, M Hardie, S A Solamy, N A Assmi, S Bernard, C Serban, H White, J Sutton, C Motherwell, P Thomas, N Soar, A Kazemi, A Tilsey, K Gregory, D Ernest, P Galt, B King, F Simmons, L Cole, L Weisbrodt, J Liang, D Hacking, J Bell, A Ghosh, S Said, Y Shehabi, N Straiton, P Kruger, E Venz, E Saylor, J Meyer, K Wetzig, S Peake, C Kurendra, P Williams, D Evans, S Kloeden, S O’Connor, J Butler, P Jarrett, D Cooper, R McAllister, C MacIsaac, A Jordan, T Bowles, E Jenkinson, D Gattas, D Hutch, H Buhr, K Deshpande, D Inskip, J Miller, T Ryan, E O'Toole, A Regli, A Palermo, J Santamaria, J Holmes, M Nicolls, C Reynolds, K McCann, S Leow, A Westbrook, E Meaney, K Brickell, S Bates, A Kuitunen, A Kukkurainen, S Varila, P May, B Stehr, A Forrest, J Barlow-Armstrong, B Ure, S Hurford, R Sol Cruz, M Sterba, B Johnson, P Diaz, S Mattos, S Sirigireddy, G Shuttleworth, P Flanagan, C Smith, D Medley, W Murphy, B Quirke, M Barry, E Kerkelä, T Krusius, J Nikkilä, M Syrjälä, K Al Khairy, F Alsaqri, H Al Wasel, E Osman, M Galligan, G Guyatt, C Brun-Buisson, N Heddle, S Walter, A Higgins, V Singh, P Doran, P Murray, C Fahey, L Burke, J Laffey, D McAuley, J Fitzgerald
Abstract
Background: It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults.
Methods: In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality.
Results: From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5%) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8%) in the short-term storage group and 594 (24.1%) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.7 to 3.1; P=0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95% CI, -2.1 to 3.0; P=0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome.
Conclusions: The age of transfused red cells did not affect 90-day mortality among critically ill adults. (Funded by the Australian National Health and Medical Research Council and others; TRANSFUSE Australian and New Zealand Clinical Trials Registry number, ACTRN12612000453886 ; ClinicalTrials.gov number, NCT01638416 .).
Source: PubMed