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Fresh, older blood equally effective in transfusions for children: study

12 December 2019 22:11
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Fresh, older blood equally effective in transfusions for children: study

CHICAGO. KAZINFORM An international study has found the risks of organ failure or death are the same for critically ill children regardless of their using fresh red blood cells that have been stored for up to seven days or older ones stored for nearly four weeks.

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The study, led by Washington University School of Medicine in St. Louis and CHU Sainte-Justine hospital in Montreal, was published online Tuesday in The Journal of the American Medical Association, Xinhua reports.

The randomized study involved 1,461 critically ill children, aged 3 days old through 16 years old, who required red blood cell transfusions at one of 50 medical centers in the United States, Canada, France, Israel and Italy.

The researchers evaluated data collected from patients, half girls, half boys, from February 2014 through November 2018.

One group of the children, or 728, received transfusions with fresh red blood cells stored for less than seven days, while the other group, or 733, received transfusions with older red cells stored predominantly from 12 to 25 days. The researchers then analyzed the risk of new or progressive multiple organ failure in the children over a 28-day period or until the patients were discharged from the hospital or died.

The findings showed that children in both groups experienced similar health outcomes. Of the children who had received fresh red blood cells, 147 or 20 percent suffered new or progressive organ impairment or death, while the same occurred in 133 or 18 percent of the children who had received the older red blood cells, a difference that was not statistically significant.

One of the study's limitations is that the researchers did not evaluate red cells that are 35 to 42 days old, the longest duration allowable in the United States. Also, the researchers examined critically ill children who received low-volume red blood cell transfusions and not those requiring large-volume red blood cell transfusions.

However, the study's relatively large size and geographic diversity allow researchers to apply results to the larger pediatric population.

«This is important because there has been a global interest in determining older red blood cells' effectiveness in critically ill children,» said co-author Philip C. Spinella, a pediatric critical care researcher and professor of pediatrics in the Division of Critical Care Medicine at Washington University. «These patients are among the sickest and most fragile.»

The study is one of the largest ever performed in pediatric critical care, and may change policies at hospitals that prefer to use fresh red cells despite the standard practice among many hospitals of first transfusing the oldest red cells in the stored inventory to minimize waste, according to the researchers.


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