Related Experiment Video
Updated: Jul 14, 2025
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Effect of red blood cell storage time in pediatric cardiac surgery patients: A subgroup analysis of a randomized
Sophie M Martin1, Marisa Tucci1, Philip C Spinella2
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Sainte Justine and Montreal Heart Institute, University of Montreal, Montreal, Québec, Canada.
Insights
Fresh red blood cell (RBC) transfusions did not reduce multiple organ dysfunction syndrome in pediatric cardiac surgery patients. Further research is needed to confirm findings on RBC storage and patient outcomes.
Area of Science:
- Pediatric critical care medicine
- Transfusion medicine
- Cardiovascular surgery
Background:
- Multiple organ dysfunction syndrome (MODS) is a significant complication in pediatric patients undergoing cardiac surgery.
- The storage duration of red blood cells (RBCs) may influence post-transfusion outcomes.
- Optimizing RBC transfusion strategies is crucial for improving patient recovery after complex surgical procedures.
Purpose of the Study:
- To investigate whether transfusing fresh red blood cells (RBCs) reduces the incidence of new or progressive multiple organ dysfunction syndrome (MODS) in pediatric patients undergoing cardiac surgery compared to standard-issue RBCs.
- To analyze secondary outcomes from the Age of Blood in Children in Pediatric Intensive Care Unit (PICU) trial.
Main Methods:
- A preplanned secondary analysis of an international randomized controlled trial involving pediatric patients after cardiac surgery with cardiopulmonary bypass.
- Patients were randomized to receive either fresh (stored ≤7 days) or standard-issue RBCs.
- The primary outcome was new or progressive MODS, assessed up to 28 days post-randomization, at PICU discharge, or death.
Main Results:
- A total of 178 patients were included, with 89 in the fresh RBCs group (median storage: 5 days) and 89 in the standard-issue RBCs group (median storage: 18 days).
- No statistically significant difference in new or progressive MODS was observed between the fresh RBCs group (48.3%) and the standard-issue RBCs group (43.2%).
- The relative risk for MODS was 1.12 (95% CI, 0.81 to 1.54; P = .49).
Conclusions:
- In neonates and children undergoing cardiac surgery, fresh RBC transfusions did not decrease the incidence of new or progressive MODS compared to standard-issue RBCs.
- The findings suggest that RBC storage duration may not be a significant factor in MODS development in this population.
- A larger clinical trial is recommended to validate these findings and further explore the impact of RBC storage age on pediatric patient outcomes.
Objective:
This study aimed to determine whether or not transfusion of fresh red blood cells (RBCs) reduced the incidence of new or progressive multiple organ dysfunction syndrome compared with standard-issue RBCs in pediatric patients undergoing cardiac surgery.
Methods:
Preplanned secondary analysis of the Age of Blood in Children in Pediatric Intensive Care Unit study, an international randomized controlled trial. This study included children enrolled in the Age of Blood in Children in Pediatric Intensive Care Unit trial and admitted to a pediatric intensive care unit after cardiac surgery with cardiopulmonary bypass. Patients were randomized to receive either fresh (stored ≤7 days) or standard-issue RBCs. The primary outcome measure was new or progressive multiple organ dysfunction syndrome, measured up to 28 days postrandomization or at pediatric intensive care unit discharge, or death.
Results:
One hundred seventy-eight patients (median age, 0.6 years; interquartile range, 0.3-2.6 years) were included with 89 patients randomized to the fresh RBCs group (median length of storage, 5 days; interquartile range, 4-6 days) and 89 to the standard-issue RBCs group (median length of storage, 18 days; interquartile range, 13-22 days). There were no statistically significant differences in new or progressive multiple organ dysfunction syndrome between fresh (43 out of 89 [48.3%]) and standard-issue RBCs groups (38 out of 88 [43.2%]), with a relative risk of 1.12 (95% CI, 0.81 to 1.54; P = .49) and an unadjusted absolute risk difference of 5.1% (95% CI, -9.5% to 19.8%; P = .49).
Conclusions:
In neonates and children undergoing cardiac surgery with cardiopulmonary bypass, the use of fresh RBCs did not reduce the incidence of new or progressive multiple organ dysfunction syndrome compared with the standard-issue RBCs. A larger trial is needed to confirm these results.
More Related Videos
05:23Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
06:22Author Spotlight: Advancing Cardiovascular Research — Tailored Langendorff Perfusion Techniques for Improved Experimental Outcomes
Published on: June 14, 2024
