Does the storage duration of blood products affect outcomes in critically ill patients?

摘要

When oxygen delivery fails to support aerobic metabolism, a complex state of physiologic dissonance emerges, broadly designated as shock. As the oxygen debt in shock mounts, cascading organ failure will lead to death unless physiologic control is restored. Two principal blood functions are impaired in this setting: oxygen transport by red blood cells (RBCs) and the balance between coagulation and fibrinolysis.This deteriorating state is compounded by the additional dysregulation of immune and endothelial function in critically ill patients who have minimal physiologic reserve to compensate for these changes. Paradoxically, mounting evidence suggests that blood component therapies (to correct anemia or coagulopathy) may exacerbate, rather than resolve, this condition-possibly due to unintended consequences of blood product processing and storage.