A randomized controlled trial comparing the outcome of critically ill adults who received fresher vs. older red cells units. (29th January 2016)

• Record Type: Journal Article
• Authors: Lacroix, J.; Hébert, P. C.; Fergusson, D. A.; Tinmouth, A.; Walsh, T.; Stanworth, S.; Campbell, H.; Boyd, J.; Burrows, H.; Hemmatapour, S.
• Is Part Of: ISBT science series. Volume 11(2016)Supplement 1
• Page Start: 332
• Page End: 336
• Publication Date: 2016-01-29
• Subjects: critical care -- outcome -- randomized controlled trial -- red blood cells -- storage lesions -- transfusion; Blood -- Periodicals; Blood -- Transfusion -- Periodicals; Immunohematology -- Periodicals; Immunopathology -- Periodicals; 615.39
• DOI: 10.1111/voxs.12206
• Languages: English
• ISSNs: 1751-2816

Abstract

Abstract : Background and Objectives: Red blood cell (RBC) units are stored up to 42 days postcollection. The standard policy is to deliver the oldest units in order to limit blood wastage. The hypothesis of the 'Age of Blood Evaluation' (ABLE) study was that the outcomes of adults transfused in intensive care units (ICU) with RBC units stored ≤7 days will be better than controls who received the oldest RBC units. Materials and Methods: The ABLE study is a double‐blind randomized controlled trial. The primary outcome measure was all‐cause 90‐day mortality postrandomization. Secondary outcomes included 28‐day, ICU and hospital mortality, acquired infections, length of ICU and hospital stay, and length of treatments. Statistical analyses were performed using an intention‐to‐treat approach. Results: From 2009 to 2014, 1211 patients were allocated to the fresh arm, 1219 to the control arm (length of storage: 6·1 ± 4·9 and 22·0 ± 8·4 days, P < 0·001). There were 448 deaths (37·0%) in the fresh arm 90‐day postrandomization, and 430 (35·3%) in the control arm (absolute risk difference: 1·7%; 95% CI: −2·1% to 5·5%). A survival analysis revealed that the hazard ratio of deaths 90 days postrandomization was 1·1% in the fresh‐blood group (95% CI: 0·9% and 1·2%). The same trend against the fresh arm intervention was observed with all but one secondary outcome measure. Conclusion: The transfusion of RBC units stored ≤7 days does not improve the outcome of critically ill adults compared to the transfusion of units stored about 3 weeks (ISRCTN44878718).