Fresh blood for everyone? Balancing availability and quality of stored RBCs
Fresh blood for everyone? Balancing availability and quality of stored RBCs
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DOI：
10.1111/j.1365-3148.2008.00870.x
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发表时间：
2008-08-01
影响因子：
1.5
通讯作者：
Dzik, W.
中科院分区：
文献类型：
--
作者：
Dzik, W.
有效、长期的红细胞离体储存是每个国家血液供应库存管理的基本要求。目前的血液储存技术是一个世纪研究的发展成果。血液在长期离体储存过程中会经历代谢和结构恶化。目前对血液储存限制的监管要求没有考虑氧气输送或临床结果。最近，人们担心储存的血液可能会对接受者产生不良后果，这引发了人们对评估新鲜血液与储存血液的临床影响的研究重新产生兴趣。 2008年，一项针对接受心脏手术的输血患者结果的回顾性研究表明，与储存少于14天的血液相比，输血前储存超过14天的血液会导致更高的围手术期死亡率。在这里，我们批判性地审视上述研究的细节。数据分析和呈现中的许多重大缺陷可能导致对血液储存年龄和围手术期死亡率的影响得出错误的结论。鉴于安全和充足的血液供应对国家医疗保健的根本重要性，应使用前瞻性研究设计来研究血液的适当储存年龄问题。
Effective, prolonged ex vivo storage of red blood cells is an essential requirement for inventory management of each nation's blood supply. Current blood storage techniques are the development of a century of research. Blood undergoes metabolic and structural deterioration during prolonged ex vivo storage. Current regulatory requirements for the limit of blood storage do not consider oxygen delivery or clinical outcomes. Recently, concern that stored blood may produce adverse outcomes in recipients has sparked renewed interest in studies that can evaluate the clinical impact of fresh vs. stored blood. In 2008, a retrospective study of outcomes among transfused patients undergoing cardiac surgery suggested that blood stored for more than 14 days prior to transfusion led to higher perioperative mortality compared with blood stored for less than 14 days. Here, we critically examine the details of the above-mentioned study. Numerous substantial flaws in data analysis and presentation may have led to an erroneous conclusion about the effect of blood storage age and perioperative mortality. Given the fundamental importance of a safe and adequate blood supply to national healthcare, the question of the proper storage age for blood should be studied using a prospective study design.