Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults

作者：Cooper D James^*; McQuilten Zoe K; Nichol Alistair; Ady Bridget; Aubron Cecile; Bailey Michael; Bellomo Rinaldo; Gantner Dashiell; Irving David O; Kaukonen Kirsi Maija; McArthur Colin; Murray Lynne; Pettila Ville; French Craig

来源：New England Journal of Medicine, 2017, 377(19): 1858-1867.

DOI：10.1056/NEJMoa1707572

BACKGROUND
It is uncertain whether the duration of red-cell storage affects mortality after transfusion among critically ill adults.
METHODS
In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality.
RESULTS
From November 2012 through December 2016, at 59 centers in five countries, 4994 patients underwent randomization and 4919 (98.5%) were included in the primary analysis. Among the 2457 patients in the short-term storage group, the mean storage duration was 11.8 days. Among the 2462 patients in the long-term storage group, the mean storage duration was 22.4 days. At 90 days, there were 610 deaths (24.8%) in the short-term storage group and 594 (24.1%) in the long-term storage group (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.7 to 3.1; P = 0.57). At 180 days, the absolute risk difference was 0.4 percentage points (95% CI, -2.1 to 3.0; P = 0.75). Most of the prespecified secondary measures showed no significant between-group differences in outcome.
CONCLUSIONS
The age of transfused red cells did not affect 90-day mortality among critically ill adults.

• 出版日期2017-11-9