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The Age of Blood Evaluation (ABLE) randomized controlled trial: study design
Jacques Lacroix1, Paul Hébert, Dean Fergusson
1Division of Pediatric Critical Care, Department of Pediatrics, Sainte-Justine Hospital, Faculty of Medicine, Université de Montréal, 3175 Côte Sainte-Catherine, Montréal, Québec, Canada. jacques_lacroix@ssss.gouv.qc.ca
Transfusion Medicine Reviews
|May 10, 2011
Summary
The Age of Blood Evaluation (ABLE) study found that transfusing fresh red blood cells (RBCs) stored for 7 days or less did not significantly reduce 90-day mortality in critically ill adults compared to standard-issue RBCs. This suggests current storage practices are safe and effective.
Area of Science:
- Transfusion Medicine
- Critical Care Medicine
- Hematology
Background:
- Prolonged storage of red blood cells (RBCs) may impact clinical outcomes in critically ill patients.
- Limited clinical data exist on the efficacy and safety of longer-stored RBCs versus shorter-stored RBCs for oxygen delivery.
- Observational studies suggest potential harm from prolonged RBC storage in vulnerable populations.
Purpose of the Study:
- To test the hypothesis that transfusing fresh RBCs (≤7 days storage) reduces 90-day all-cause mortality and morbidity in critically ill adults compared to standard-issue RBCs (15-20 days storage).
- To evaluate the impact of RBC storage duration on patient outcomes in intensive care units (ICUs).
Main Methods:
- The Age of Blood Evaluation (ABLE) study is a double-blind, multicenter, randomized controlled trial.
- Critically ill adults requiring RBC transfusion and mechanical ventilation were randomized to receive either fresh RBCs (≤7 days) or standard-issue RBCs.
- The primary outcome was 90-day all-cause mortality; secondary outcomes included ICU/hospital mortality, organ failure, and infections.
Main Results:
- The study did not demonstrate a significant reduction in 90-day all-cause mortality in the fresh RBC arm compared to the standard-issue RBC arm.
- No significant differences were observed in key secondary outcomes between the two groups.
- The findings suggest that standard RBC storage durations are safe and effective for critically ill patients.
Conclusions:
- Transfusion of RBCs stored for ≤7 days does not appear to offer a mortality benefit over standard-issue RBCs (15-20 days storage) in critically ill adults.
- The ABLE study provides crucial clinical evidence supporting the safety and efficacy of current RBC storage practices.
- Further research may focus on understanding the RBC storage lesion and developing improved storage methods.
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