The age of transfused blood predicts hematocrit response among critically ill surgical patients

Abstract Background In vitro data suggest that erythrocytes undergo storage time-dependent degradation, eventuating in hemolysis. We hypothesize that transfusion of old blood, as compared with newer blood, results in a smaller increment in hematocrit. Methods We performed an analysis of packed red b...

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Bibliographic Details
Published in:The American journal of surgery 2012-09, Vol.204 (3), p.269-273
Main Authors: Pieracci, Fredric M., M.D., M.P.H, Moore, Ernest E., M.D, Chin, Teresa, M.D, Townsend, Nicole, M.D, Gonzalez, Eduardo, M.D, Burlew, Clay C., M.D, Barnett, Carlton C., M.D
Format: Article
Language:English
Subjects:
Academic Medical Centers
Acute coronary syndromes
Adult
Age of blood
Aged
Anemia
Biological and medical sciences
Blood transfusions
Chi-Square Distribution
Critical Care - methods
Critical Care - standards
Critical Illness
Cross-Sectional Studies
Erythrocyte Transfusion - standards
Female
General aspects
Hematocrit
Humans
Linear Models
Male
Medical sciences
Middle Aged
Mortality
Outcomes
Studies
Surgery
Time Factors
Transfusion
Treatment Outcome
Variables
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Summary:Abstract Background In vitro data suggest that erythrocytes undergo storage time-dependent degradation, eventuating in hemolysis. We hypothesize that transfusion of old blood, as compared with newer blood, results in a smaller increment in hematocrit. Methods We performed an analysis of packed red blood cell transfusions administered in the surgical intensive care unit. Age of blood was analyzed as continuous, dichotomized at 14 days (old vs new), and grouped by weeks old. Results A total of 136 U of packed red blood cells were given to 52 patients; 110 (80.9%) were 14 days old or more. A linear, inverse correlation was observed between the age of blood and the increment in hematocrit (r2 = −.18, P = .04). The increment in hematocrit was greater after transfusion of new as compared with old blood (5.6% vs 3.5%, respectively; P = .005). A linear relationship also was observed between the age of transfused blood in weeks and the increment in hematocrit ( P = .02). Conclusions There is an inverse relationship between the age of blood and the increment in hematocrit. The age of blood should be considered before transfusion of surgical patients with intensive care unit anemia.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2011.10.017