Immune Effects of RBC Storage in Critically Ill Patients.

摘要

Combat casualties are specifically at risk of adverse effects resulting from the use of RBCs of increased storage age. A large multicenter randomized controlled trial in 30 Canadian centers of 2500 critically ill patients called the Age of Blood Evaluation (ABLE) trial has been funded. In this trial of critically ill patients, which includes patients with traumatic injuries, study groups will be randomized to either RBCs of less than 8 days storage time or standard RBC storage time (mean 21 days). The primary outcome of this trial is 90 day mortality. Secondary outcomes include severity of multiple organ dysfunction syndrome, serious thrombotic events and nosocomial infections, and ICU and hospital length of stay. Prospective clinical studies investigating the mechanisms and clinical outcomes associated with increased or decreased RBC storage age in critically ill patients including traumatic injury have not been performed. The ABLE study presents a unique and probably one - time opportunity to investigate mechanisms in the context of clinical outcomes for well - characterized study groups. This study is designed to determine specific mechanisms of adverse effects related to the RBC storage age in transfused critically ill patients enrolled in the ABLE study. This ancillary study will specifically determine if the RBC unit storage time affects patient's immune function, inflammation, coagulation, microparticle concentrations and michrochimerism.