PURPOSE OF REVIEW: To review the current literature on the role of storage time of transfused red blood cells on microcirculation and tissue oxygenation in critically ill patients. RECENT FINDINGS: The actual target of transfusion of red blood cells is the maintenance of adequate tissue oxygenation. Recent studies suggest that, besides hemoglobin concentration, mixed or central venous oxygen saturation may also be used as surrogate markers for the estimation of transfusion requirement. However, variables reflecting the concrete target of transfusion, that is tissue oxygenation, appear to be more suitable in this regard. In addition, there is an increasing body of evidence on adverse effects of transfusion of--primarily older--red blood cells on tissue oxygenation and microcirculation. This might be explained, at least in part, by so-called storage lesions, which commence immediately after donation of blood and aggravate over time. SUMMARY: Large-scale prospective randomized trials are needed to explicitly clarify the role of new transfusion triggers, such as tissue oxygenation, and the impact of storage lesions of packed red blood cells on tissue oxygenation and--more important--on clinical outcomes in different patient populations.
PURPOSE OF REVIEW: To review the current literature on the role of storage time of transfused red blood cells on microcirculation and tissue oxygenation in critically illpatients. RECENT FINDINGS: The actual target of transfusion of red blood cells is the maintenance of adequate tissue oxygenation. Recent studies suggest that, besides hemoglobin concentration, mixed or central venous oxygen saturation may also be used as surrogate markers for the estimation of transfusion requirement. However, variables reflecting the concrete target of transfusion, that is tissue oxygenation, appear to be more suitable in this regard. In addition, there is an increasing body of evidence on adverse effects of transfusion of--primarily older--red blood cells on tissue oxygenation and microcirculation. This might be explained, at least in part, by so-called storage lesions, which commence immediately after donation of blood and aggravate over time. SUMMARY: Large-scale prospective randomized trials are needed to explicitly clarify the role of new transfusion triggers, such as tissue oxygenation, and the impact of storage lesions of packed red blood cells on tissue oxygenation and--more important--on clinical outcomes in different patient populations.
Authors: C Makena Hightower; Beatriz Y Salazar Vázquez; Pedro Cabrales; Amy G Tsai; Seetharama A Acharya; Marcos Intaglietta Journal: Transfusion Date: 2012-05-03 Impact factor: 3.157
Authors: Daniel N Holena; Giora Netzer; Russell Localio; Robert J Gallop; Scarlett L Bellamy; Nuala J Meyer; Michael G S Shashaty; Paul N Lanken; Sandra Kaplan; Patrick M Reilly; Jason D Christie Journal: J Trauma Acute Care Surg Date: 2012-10 Impact factor: 3.313
Authors: Lars B Holst; Nicolai Haase; Jørn Wetterslev; Jan Wernerman; Anders Aneman; Anne B Guttormsen; Pär I Johansson; Sari Karlsson; Gudmundur Klemenzson; Robert Winding; Lars Nebrich; Carsten Albeck; Marianne L Vang; Hans-Henrik Bülow; Jeanie M Elkjær; Jane S Nielsen; Peter Kirkegaard; Helle Nibro; Anne Lindhardt; Ditte Strange; Katrin Thormar; Lone M Poulsen; Pawel Berezowicz; Per M Bådstøløkken; Kristian Strand; Maria Cronhjort; Elsebeth Haunstrup; Omar Rian; Anders Oldner; Asger Bendtsen; Susanne Iversen; Jørn-Åge Langva; Rasmus B Johansen; Niklas Nielsen; Ville Pettilä; Matti Reinikainen; Dorte Keld; Siv Leivdal; Jan-Michael Breider; Inga Tjäder; Nanna Reiter; Ulf Gøttrup; Jonathan White; Jørgen Wiis; Lasse Høgh Andersen; Morten Steensen; Anders Perner Journal: Trials Date: 2013-05-23 Impact factor: 2.279