TY - JOUR
T1 - Association between length of storage of red blood cell units and outcome of critically ill children
T2 - A prospective observational study
AU - Karam, Oliver
AU - Tucci, Marisa
AU - Bateman, Scot T.
AU - Ducruet, Thierry
AU - Spinella, Philip C.
AU - Randolph, Adrienne G.
AU - Lacroix, Jacques
N1 - Funding Information:
We would like to thank the 30 sites of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network investigators that participated in the data collection. The original study (supported by Johnson and Johnson Pharmaceutical Research and Development) aimed to assess a possible indication for erythropoietin in PICU. We would also like to thank Dr Katia Boven, from Johnson and Johnson Pharmaceutical, for her participation in the original study and her helpful comments regarding the present manuscript. This ancillary study was financed by the Fonds de la Recherche en Santé du Québec (# 3568 and 3398) and the Fonds National Suisse de la Recherche Scientifique (#PBGE33-121210).
PY - 2010/4/8
Y1 - 2010/4/8
N2 - Introduction: Transfusion is a common treatment in pediatric intensive care units (PICUs). Studies in adults suggest that prolonged storage of red blood cell units is associated with worse clinical outcome. No prospective study has been conducted in children. Our objectives were to assess the clinical impact of the length of storage of red blood cell units on clinical outcome of critically ill children.Methods: Prospective, observational study conducted in 30 North American centers, in consecutive patients aged <18 years with a stay ≥ 48 hours in a PICU. The primary outcome measure was the incidence of multiple organ dysfunction syndrome after transfusion. The secondary outcomes were 28-day mortality and PICU length of stay. Odds ratios were adjusted for gender, age, number of organ dysfunctions at admission, total number of transfusions, and total dose of transfusion, using a multiple logistic regression model.Results: The median length of storage was 14 days in 296 patients with documented length of storage. For patients receiving blood stored ≥ 14 days, the adjusted odds ratio for an increased incidence of multiple organ dysfunction syndrome was 1.87 (95% CI 1.04;3.27, P = 0.03). There was also a significant difference in the total PICU length of stay (adjusted median difference +3.7 days, P < 0.001) and no significant change in mortality.Conclusions: In critically ill children, transfusion of red blood cell units stored for ≥ 14 days is independently associated with an increased occurrence of multiple organ dysfunction syndrome and prolonged PICU stay.
AB - Introduction: Transfusion is a common treatment in pediatric intensive care units (PICUs). Studies in adults suggest that prolonged storage of red blood cell units is associated with worse clinical outcome. No prospective study has been conducted in children. Our objectives were to assess the clinical impact of the length of storage of red blood cell units on clinical outcome of critically ill children.Methods: Prospective, observational study conducted in 30 North American centers, in consecutive patients aged <18 years with a stay ≥ 48 hours in a PICU. The primary outcome measure was the incidence of multiple organ dysfunction syndrome after transfusion. The secondary outcomes were 28-day mortality and PICU length of stay. Odds ratios were adjusted for gender, age, number of organ dysfunctions at admission, total number of transfusions, and total dose of transfusion, using a multiple logistic regression model.Results: The median length of storage was 14 days in 296 patients with documented length of storage. For patients receiving blood stored ≥ 14 days, the adjusted odds ratio for an increased incidence of multiple organ dysfunction syndrome was 1.87 (95% CI 1.04;3.27, P = 0.03). There was also a significant difference in the total PICU length of stay (adjusted median difference +3.7 days, P < 0.001) and no significant change in mortality.Conclusions: In critically ill children, transfusion of red blood cell units stored for ≥ 14 days is independently associated with an increased occurrence of multiple organ dysfunction syndrome and prolonged PICU stay.
UR - http://www.scopus.com/inward/record.url?scp=77950676174&partnerID=8YFLogxK
U2 - 10.1186/cc8953
DO - 10.1186/cc8953
M3 - Article
C2 - 20377853
AN - SCOPUS:77950676174
SN - 1364-8535
VL - 14
JO - Critical Care
JF - Critical Care
IS - 2
M1 - R57
ER -