• Injury · Mar 2014

    Impact of the age of transfused red blood cells in the trauma population: A feasibility study.

    • Stephen M Cohn, Mark DeRosa, Ashwini Kumar, Chantal Harrison, Daniel Dent, Sunthosh Sivam, Janet McCarthy, Sherrie Warner, Susan Williams, Joel E Michalek, and Philip Spinella.
    • University of Texas Health Science Center at San Antonio, Department of Surgery, Division of Trauma and Emergency Surgery, 7703 Floyd Curl Drive, MC 7740, San Antonio, TX 78229, United States. Electronic address: cohn@uthscsa.edu.
    • Injury. 2014 Mar 1;45(3):605-11.

    UnlabelledFollowing injury, transfusion of red blood cells (RBCs) of increased storage duration has been associated with an increased morbidity and mortality. Prospective trials focusing on the impact of the storage age of RBCs in severely bleeding trauma patients have failed to accrue patients. This has been attributed to an inability to maintain a large inventory of fresh RBCs, and the difficulties in obtaining consent in severely bleeding trauma patients. To address these issues, we performed a prospective, observational pilot study to evaluate the feasibility of conducting a trial focusing on RBC age in patients following injury.MethodsPatients with bleeding due to trauma were transfused RBCs ≤10 day old if they were ABO blood Type O (Group O) or were transfused the oldest RBCs in inventory if they were Type A, B or AB (Group A/B/AB). Clinicians were unaware of the specific age of the RBCs.Results63 patients were analyzed (Group O, n=19; Group A/B/AB, n=44). Half of all patients had severe injuries ISS (median 22). The median admission base deficit was -5 mEq/L, and median total 24h use of RBC and FFP was 1.2 L. The age of RBCs transfused to Group O was significantly lower than for Group A/B/AB [median (IQR) A/B/AB=18.4 (11.4-25.4) days, and Group O=6 (4.2-7.8) days; p<0.001].ConclusionsIt appears feasible to conduct a RBC age trial in trauma patients using ABO blood type to construct comparative groups. Adequate RBC age separation between cohorts and reduced RBC age in the "young" group of patients who received units ≤10 days old was achieved.Copyright © 2013 Elsevier Ltd. All rights reserved.

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