Does red blood cell storage time still influence ICU survival?
Does red blood cell storage time still influence ICU survival?
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DOI：
10.1016/j.tracli.2008.06.001
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发表时间：
2008-09-01
影响因子：
1.7
通讯作者：
Timsit, J. -F.
中科院分区：
文献类型：
--
作者：
Dessertaine, G.;Hammer, L.;Timsit, J. -F.
Objective. - 很少有研究表明，老化的浓缩红细胞（RBC）输注对ICU患者的预后有负面影响，可能与RBC白细胞耗竭可减少的储存性病变有关。本研究的目的是评估老年白细胞减少的红细胞包对ICU患者预后的影响。在内科重症监护病房进行的回顾性、观察性、队列研究。2005年和2006年期间收治的需要输血的并发症患者。我们记录了患者的人口统计学数据、红细胞单位数和每个红细胞的年龄。ICU的长度、ICU停留期间的死亡率。- 共纳入534例患者，总死亡率为26.6%，ICU住院时间为6天（3-14天），SAPS II为48（35-62天）。平均每例患者输注的红细胞数为5.9（22.7% < 14天，57.3% < 21天）。死亡患者组的RBC数量显著较高，但RBC储存少于21天的比率没有差异（54% vs 60% p = 0.21）。在多变量logistic模型中，ICU死亡的独立预测因子为SAPS 11（OR = 1.02/点，p < 0.001），RBC数量（OR = 1.08/RBC，1）< 0.001）。ICU住院时间（p < 0.001）。在多变量考克斯模型中引入红细胞年龄作为时间依赖性协变量时获得了类似的结果。- 红细胞输血病我们的ICU是旧的。ICU结局与输注的白细胞减少的RBC数量独立相关。但不适合他们的年龄(C)2008年，Elsevier Masson SAS。图斯所有权保留。
Objective. - Few studies have shown that aged packed red blood cells (RBC) transfusion negatively influenced the outcome of ICU patients, probably related to storage lesions which could be decreased by leukodepletion of RBC. The Purpose of this, study was to evaluate the impact of aged leukodepleted-RBC pack, on the outcome Of ICU patients.Design. Retrospective, observational, cohort study in a Medical Intensive Care Unit.Patients. Consecutive patients admitted during the years 2005 and 2006, and requiring a transfusion. We recorded patient's demographic data, number of RBC unit and age of each RBC. length of ICU, mortality during ICU stay.Results. - Five hundred and thirty-four patients were included with of global mortality was 26.6%, length of stay in ICU six days (3-14) and SAPS II 48 (35-62). RBC equaling to 5.9 were transfused per patients (22.7% < 14 days and 57.3% < 21 days). The number of RBC was significantly higher in the dead patients group, but the rate of RBC stored less than 21 days was not different (54% versus 60% p = 0.21). In a multivariate logistic model, independent predictors of ICU death were SAPS 11 (OR = 1.02 per point, p < 0.001), number of RBC (OR = 1.08 per RBC, 1) < 0.001). length of stay in ICU (p < 0.001). Similar results were obtained while introducing the age of RBC as lime dependent covariates in a multivariate Cox's model.Conclusions. - RBC transfused ill our ICU are old. The ICU Outcome is independently associated with the number of leucodepleted RBC transfused. but not with their age. (C) 2008 Elsevier Masson SAS. Tous droits reserves.