old vs new blood

 Q: Freshly acquired pRBC has better outcomes in critically ill patients than stored pRBC?

A) true

B) false

Answer: B

Multiple trials have now established that there is no difference in mortality, morbidity, length of stay (LOS) and coagulation or immune parameters in patients who received either fresh blood or old blood. Few major trials in this regard are 

1. INFORM trial (Informing Fresh versus Old Red Cell Management), 
2. ABLE trial (Age of Blood Evaluation), 
3. TRANSFUSE trial (Standard Issue Transfusion versus Fresher Red-Cell Use in Intensive Care), and 
4.  RECESS trial (Red Cell Storage Duration Study)

#hematology

References:

1. Heddle NM, Cook RJ, Arnold DM, et al. Effect of short-term vs. long-term blood storage on mortality after transfusion. N Engl J Med. 2016;375:1937–45. 

2. Lacroix J, Hébert PC, Fergusson DA, et al. Age of transfused blood in critically ill adults. N Engl J Med 2015; 372:1410. 

3. Steiner ME, Ness PM, Assmann SF, et al. Effects of red-cell storage duration on patients undergoing cardiac surgery. N Engl J Med 2015; 372:1419. 

4. Spinella PC, Sniecinski RM, Trachtenberg F, et al. Effects of blood storage age on immune, coagulation, and nitric oxide parameters in transfused patients undergoing cardiac surgery. Transfusion 2019; 59:1209. 

5. Alexander PE, Barty R, Fei Y, et al. Transfusion of fresher vs older red blood cells in hospitalized patients: a systematic review and meta-analysis. Blood 2016; 127:400. 

6. Irving A, Higgins A, Ady B, Bellomo R, Cooper DJ, French C, Gantner D, Harris A, Irving DO, Murray L, Nichol A, Petrie D, McQuilten ZK; Standard Issue Transfusion versus Fresher Red-Cell Use in Intensive Care (TRANSFUSE) Investigators and Australian and New Zealand Intensive Care Society Clinical Trials Group. Fresh Red Cells for Transfusion in Critically Ill Adults: An Economic Evaluation of the Standard Issue Transfusion Versus Fresher Red-Cell Use in Intensive Care (TRANSFUSE) Clinical Trial. Crit Care Med. 2019 Jul;47(7):e572-e579. doi: 10.1097/CCM.0000000000003781. PMID: 31008734.