Canadian Journal of Anaesthesia

, Volume 44, Issue 12, pp 1256–1261 | Cite as

Association of mortality with age of blood transfused in septic ICU patients

  • F. Robert Purdy
  • Martin G. Tweeddale
  • Pamela M. Merrick
Reports of Investigation

Abstract

Purpose

To determine, retrospectively, the age of packed red blood cell (PRBC) units transfused to patients admitted to the ICU with the diagnosis of severe sepsis and to correlate this vanable with outcome.

Methods

All patients admitted to the ICU during 1992 with a diagnosis of severe sepsis were selected retrospectively. The criteria for the diagnosis of severe sepsis and septic shock were based on established guidelines. For each patient the total number of PRBC units transfused, the number of units transfused before, during and after the septic episode, and the age of each PRBC unit transfused were recorded.

Results

Of the 31 patients admitted to the ICU with severe sepsis, 19 died and 12 survived. No statistical differences between survivors and nonsurvivors were found with respect to age, sex, number of days in ICU, duration of sepsis, incidence of septic shock, admission Apache Il score or total number of PRBC units transfused. During sepsis the median age of PRBC units transfused to survivors was 17 days (range 5–35)vs 25 days (range 9–36) for nonsurvivors (P < 0.0001). A negative correlation (r = −0.73) was found between the proportion of PRBC units of a given age transfused to survivors and increasing age of PRBC.

Conclusion

This is the first study to report a correlation of mortality with the age of PRBC transfused. The cause of this association is unclear. If this association is confirmed by a prospective randomised tnal it would have major implications for the use of PRBC in severe sepsis.

Résumé

Objectif

Déterminer rétrospectivement l’âge des concentrés érythrocytaires (CE) transfusés à des patients admis à l’unité des soins intensifs (USI) avec un diagnostic de sepsis grave et vérifier si cette vanable a une corrélation avec le devenir des patients.

Méthodes

Tous les patients admis à l’USI en 1992 avec un diagnostic de sepsis grave ont fait l’objet de cette recherche rétrospective. Les signes et symptômes usuels ont servi à établir les critères de sepsis grave et de choc septique. Pour chacun des patients la quantité totale des CE transfusés, le nombre de CE transfusés avant, pendant et après l’épisode septique et l’âge de chaque CE transfusé ont été enregistrés.

Résultats

Parmi les 31 patients admis à l’USI pour sepsis grave, 19 sont décédés et 12 ont survécu. Il n’y avait pas de différence statistique entre survivants et non survivants en rapport à l’âge, le sexe, la durée du séjour à l’USI, la durée du sepsis, l’incidence du choc septique, le score APACHE Il à l’admission et le nombre de CE transfusés. Au cours du sepsis, l’âge médian des CE transfusés était de 17 jours (écart 5–35)vs 25 jours (écart 9–39) pour les non survivants (P < 0,0001). On a trouvé une corrélation négative (r = −0,73) entre la proportion de CE d’un âge déterminé transfusé aux survivants et l’accroissement de l’âge des CE.

Conclusion

Il s’agit ici de la première étude concluant à une corrélation avec l’âge des CE transfusés. La raison de cette association n’est pas claire. Si une étude aléatoire prospective parvient à confirmer cette assertion, elle aurait des répercussions majeures sur la transfusion de CE dans le sepsis grave.

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Copyright information

© Canadian Anesthesiologists 1997

Authors and Affiliations

  • F. Robert Purdy
    • 1
  • Martin G. Tweeddale
    • 1
  • Pamela M. Merrick
    • 1
  1. 1.Intensive Care Unit and Department of AnaesthesiaVancouver Hospital and Health Sciences CentreVancouverCanada

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