Relationship between transfusion of packed red blood cells, plasma free hemoglobin and storage time in patients with severe trauma

Abstract

Issue Title: ESICM LIVES 2015

Chacn Alves et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A916 http://www.icm-experimental.com/content/3/S1/A916

POSTER PRESENTATION Open Access

Relationship between transfusion of packed red blood cells, plasma free hemoglobin and storage time in patients with severe trauma

S Chacn Alves*, M Chico Fernndez, C Garca Fuentes, A Del Pino Ramrez, N Zurera Plaza, L Umezawa Makikado,

E Alted Lpez, JC Montejo Gonzlez

From ESICM LIVES 2015

Berlin, Germany. 3-7 October 2015

Introduction

Transfusion is a treatment in continuing debate and controversy. In recent years, there has been an increased interest about the storage lesions and its possible clinical consequences, and in addition, there has been an increased concern about the effect of the age of packed red blood cells.

Objectives

Determining the influence of the age of the packed cells in stable trauma patients in hemolysis parameters and in the performance of transfusion.

Methods

Prospective, descriptive, observational study on a cohort of patients with severe trauma, that were admitted more than 72 hours in the ICU of Trauma and Emergency of a high complexity hospital, without active bleeding.November 2012 to January 2014. It was measured hemoglobin (hb), hematocrit (hct), plasma free hemoglobin (fhb) by HemoCue, bilirrubin and LDH before and after transfusion of one packed red blood cells. The attending physician determined the transfusion requirement, individually. We collected data about storage and characteristics of packed red blood cells and their age ("young blood if it was less than 14 days and old blood if it was more than 14 days). Statistical data were analyzed by SPSS 16.0 considering statistically significant at P < 0.05.

Results

34 transfusions were performed, with average threshold of6.8 0.3 g / dl for hb and 20.3% 1.6% for hematocrit. The most common blood group was the group O+ (56% of transfusions). The plasma free hemoglobin average pre-transfusion was 0.13 0.06 g/dl compared to 0.19 0.06 g/dl post-transfusion (p < 0.05). Increasing bilirrubin level was significant too, with a mean value of pre-transfusion 0.88 0.90 mg/dl vs 1.14 1.17 mg/dl post-transfusion. The average pre-transfusion LDH was 371.24 197.75 U/L and posttransfusion was 396.39 199.46 U/L (p = 0.06). These figures vary depending on the age of the blood, with an average increase fhb of 0.057 0.11 g/dl for young blood versus 0.064 0.062 g/dl for old blood (p > 0,05)

Hb performance adjusted to body surface is higher in young versus old blood, with an average of 0.91g / dl per kg / m2 0.58 vs 0,51g / dl per kg / m2 0.13 for hb and 2.88% per Kg / m2 1.84 vs 1.57% per Kg / m2 0.52 for hematocrit (p < 0.001).

Conclusions

The transfusion of one packed red blood cells increases BPH and hemolysis significantly. Young blood transfusion has higher performance.

Published: 1 October 2015

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Hospital Universitario Doce de Octubre, Medicina Intensiva, UCI de Trauma y Emergencias, Madrid, Spain

2015 Chacn Alves et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0

Web End =http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Chacn Alves et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A916 http://www.icm-experimental.com/content/3/S1/A916

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doi:10.1186/2197-425X-3-S1-A916Cite this article as: Chacn Alves et al.: Relationship between transfusion of packed red blood cells, plasma free hemoglobin and storage time in patients with severe trauma. Intensive Care Medicine Experimental 2015 3 (Suppl 1):A916.

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