Age of Transfused Blood in Critically Ill Adults

Jacques Lacroix (1) , Paul C. Hébert (2) , Dean A. Fergusson (3) , Alan Tinmouth , Deborah J. Cook , John C. Marshall , Lucy Clayton , Lauralyn Mcintyre , Jeannie Callum , Alexis F. Turgeon , Morris A. Blajchman , Timothy S. Walsh (4, 5) , Simon J. Stanworth , Helen Campbell , Gilles Capellier (6) , Pierre Tiberghien (7) , Laurent Bardiaux , Leo van de Watering , Nardo J. van Der Meer , Elham Sabri , Dong Vo , Canadian Critical Care Trials Group Souweine (8)

1 CRISIS - Centre de recherche interuniversitaire sur la communication, l’information et la société
2 Biodiversity institute of Ontario
3 Clinical Epidemiology Unit
4 NICTA - National ICT Australia [Sydney]
5 UNSW - University of New South Wales [Sydney]
6 Réanimation Médicale CHRU Besançon
7 RIGHT - Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098)
8 LMGE - Laboratoire Microorganismes : Génome et Environnement

Between March 2009 and May 2014, at 64 centers in Canada and Europe, 1211 patients were assigned to receive fresh red cells (fresh-blood group) and 1219 patients were assigned to receive standard-issue red cells (standard-blood group). Red cells were stored a mean (±SD) of 6.1±4.9 days in the fresh-blood group as compared with 22.0±8.4 days in the standard-blood group (P<0.001). At 90 days, 448 patients (37.0%) in the fresh-blood group and 430 patients (35.3%) in the standard-blood group had died (absolute risk difference, 1.7 percentage points; 95% confidence interval [CI], -2.1 to 5.5). In the survival analysis, the hazard ratio for death in the fresh-blood group, as compared with the standard-blood group, was 1.1 (95% CI, 0.9 to 1.2; P=0.38). There were no significant between-group differences in any of the secondary outcomes (major illnesses; duration of respiratory, hemodynamic, or renal support; length of stay in the hospital; and transfusion reactions) or in the subgroup analyses. CONCLUSIONS: Transfusion of fresh red cells, as compared with standard-issue red cells, did not decrease the 90-day mortality among critically ill adults.

Domaines: Protistologie; Ingénierie biomédicale; Médecine humaine et pathologie

Jacques Lacroix, Paul C. Hébert, Dean A. Fergusson, Alan Tinmouth, Deborah J. Cook, et al.. Age of Transfused Blood in Critically Ill Adults. New England Journal of Medicine, 2015, 372 (15), pp.1410 - 1418. ⟨10.1056/NEJMoa1500704⟩. ⟨hal-01393954⟩