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Publications

Journal Article Ppublish

PubMed: 40115464 DOI: 10.21037/tp-24-433

Impacts of red blood cell suspension storage on pediatric outcomes: pediatric medicine and pediatric surgery.

Transl Pediatr 14(2):187-199

Authors: Mingwei Yin, Guannan Bai, Yangyang Zhong, Jihua Ma, Dandan Tian, Xuying Guo, Chao Zhou, Baohai Chen, Xuejun Chen, Zhigang Gao

Affiliations

  • Department of Blood Transfusion, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, Hangzhou, China.
  • Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, Hangzhou, China.
  • Department of Clinical Laboratory, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, Hangzhou, China.
  • Renji College, Wenzhou Medical University, Wenzhou, China.
  • Information Center, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, Hangzhou, China.
  • Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, Hangzhou, China.

Abstract

Background

Impacts of red blood cell (RBC) suspension storage on outcomes in pediatric patients receiving RBC transfusions remains uncertain. Therefore, our objective is to examine the association between RBC storage duration and outcomes in pediatric patients.

Methods

A retrospective study was conducted on 222 patients admitted to medical and surgical departments at our center in 2021. Primary outcomes assessed were 28-day mortality and length of hospital stays, while secondary outcomes included transfusion-related complications, total volume of RBC transfusions, number of RBC transfusions, and interval between RBC transfusions. Patients were categorized into the fresh group (≤10 days) and the old group (≥21 days) based on RBC storage time.

Results

Following RBC transfusions, there was a significant improvement in post-transfusion hemoglobin, RBC counts, and hematocrit in both internal medicine and surgery departments. Among medical patients, the fresh group exhibited a shorter hospital stays compared to the old group [hazard ratio (HR) =0.677; 95% confidence interval (CI): 0.476 to 0.961; P=0.03]; however, no significant difference was observed among surgical patients. Within surgical patients, the fresh group showed longer interval between RBC transfusions (HR =2.235; 95% CI: 1.145 to 4.363; P=0.02) and required fewer number of RBC transfusions (P=0.04). No significant differences were found in hemoglobin, RBC counts, hematocrit, K, Ca, lactate (Lac), and pH after RBC transfusions.

Conclusions

RBC storage was not associated with 28-day mortality in medical and surgical pediatric patients. Fresh RBC transfusions were found to reduce the length of hospital stays by 32.3% in medical patients, extend the interval between RBC transfusions by 1.235 times and decrease the number of RBC transfusions in surgical patients.

MeSH

Hematocrit, Cells, Blood Transfusion, Hemoglobins, Mortality, Erythrocytes, Blood, Suspensions, Blood Cells, Pediatrics