Red Blood Cell Transfusion and Associated Outcomes

Many studies have detailed increasing risks of morbidity and mortality associated with anemia in critically ill patients.  Despite these findings, transfusion of red blood cells (RBCs) to optimize oxygen delivery has been shown to carry its own inherent risks, ranging from the development of acute lung injury to immunomodulation to problems with the storage lesion and oxygen delivery. A study by Hassan et al adds to the mounting evidence regarding the deleterious effects of RBC transfusion by retrospectively looking at the impact of transfusion on pediatric trauma patients. The authors compared the outcomes of 81 children with trauma who were transfused with RBCs to 282 who did not receive any blood products.

They found that transfusion of packed RBCs is associated with higher risk of adverse outcomes independent of injury severity. Due to its retrospective nature, this study does not provide any new evidence proving that transfusion of RBCs can be harmful to critically ill patients, but it adds to the evidence of the effects in pediatric trauma patients.

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