Association between storage age of transfused red blood cells and clinical outcomes in critically ill adults: A meta-analysis of randomized controlled trials - PubMed (original) (raw)

Meta-Analysis

. 2019 Dec;43(9):528-537.

doi: 10.1016/j.medin.2018.07.004. Epub 2018 Sep 18.

[Article in English, Spanish]

Affiliations

Meta-Analysis

Association between storage age of transfused red blood cells and clinical outcomes in critically ill adults: A meta-analysis of randomized controlled trials

[Article in English, Spanish]

X Zhou et al. Med Intensiva (Engl Ed). 2019 Dec.

Abstract

Objectives: A meta-analysis was performed to assesses the effect of storage age of transfused red blood cells (RBCs) upon clinical outcomes in critically ill adults.

Methods: A comprehensive search was conducted in the PubMed, OVID, Web of Science and Cochrane databases for randomized controlled trials (RCTs) comparing the transfusion of fresher versus older RBCs in critically ill adults from database inception to December 2017. The primary endpoint was short-term mortality, and the secondary endpoints were the duration of intensive care unit (ICU) and hospital stay. The pooled odds ratios (OR) and mean differences (MD) were calculated using Stata/SE 11.0.

Results: A total of six RCTs were identified, of which four were multicenter studies, while two were single-center trials. The pooled results indicated that the transfusion of fresher RBCs was not associated to a decrease in short-term mortality compared with the transfusion of older RBCs (random-effects OR=1.04, 95% confidence interval (CI): 0.96-1.13, P=0.312; I2=0.0%; six trials; 18240 patients), regardless of whether the studies were of a multi-center (random-effects OR=1.04, 95% CI: 0.96-1.13, P=0.292; I2=0.0%) or single-center nature (random-effects OR=1.16, 95% CI: 0.28-4.71, P=0.839; I2=56.7%), or with low risk of bias (random-effects OR=1.04, 95% CI: 0.94-1.16, P=0.445; I2=0.0%). In addition, the transfusion of fresher RBCs did not reduce the geometric mean duration of ICU stay (1.0% increase in geometric mean, 95% CI: -3.0 to 5.1%, P=0.638; I2=81.5%; four trials; 7550 patients) or the geometric mean duration of hospital stay (0.0% increase in geometric mean, 95% CI: -3.9 to 4.1%, P=0.957; I2=7.4%; four trials; 7550 patients) compared with the transfusion of older RBCs.

Conclusions: The transfusion of fresher RBCs compared with older RBCs was not associated to better clinical outcomes in critically ill adults.

Keywords: Critically ill; Críticamente enfermo; Glóbulo rojo; Intensive care unit; Mortalidad; Mortality; Red blood cell; Transfusion; Transfusión; Unidad de cuidados intensivos.

Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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