Effects of Red Blood Cells Stored for Different Periods on Lung Injury in Rabbits With Endotoxic Shock

This study investigated the effects of red blood cell (RBC) storage time in a rabbit model of endotoxic shock by assessing lung injury, surfactant protein-A (SP-A) expression, oxidative stress markers, and cytokine levels. Male New Zealand rabbits were divided into eight groups (n = 8): control, blood loss, endotoxin, blood loss + endotoxin, and four treatment groups receiving RBCs stored for 0, 7, 14, or 21 days. Following lipopolysaccharide injection, measurements were taken for interleukin (IL)-1β, IL-8, tumor necrosis factor-α, lung wet/dry weight ratio, malondialdehyde, superoxide dismutase, myeloperoxidase, nitric oxide synthase, and SP-A. Results showed that transfusion of RBCs, particularly those stored for longer durations, aggravated lung damage after endotoxin shock. Groups receiving RBCs stored for ≥14 days displayed significantly more severe lung edema, histopathological injury, and higher levels of oxidative stress markers compared with those receiving fresher (0 or 7 days) RBCs. Concurrently, antioxidant activity was diminished, and SP-A levels were significantly reduced. Notably, the proinflammatory cytokines IL-1β and IL-8 reached their highest concentrations in the group transfused with 21 day old RBCs. These findings suggest that for transfusion during endotoxic shock, RBCs stored for less than 14 days are preferable. https://links.lww.com/ASAIO/B918.