Old blood as good as fresh blood in critically ill patients

Recent CCCTG research provides reassuring evidence about the safety of blood routinely transfused to critically ill patients.

CCCTG researchers have developed a significant research agenda on blood transfusion including studies focused on transfusion thresholds, blood storage, the use of alternatives to transfusion, resuscitation fluids, cardiac resuscitation and trauma. 

The Age of Blood Evaluation (ABLE) study was published today in the New England Journal of Medicine.

In 2009, Drs. Jacques Lacroix (Sainte-Justine University Hospital Research Center), Dean Ferguson and Alan Tinmouth (both of The Ottawa Hospital), and Paul Hébert (Centre de recherche du centre hospitalier de l’Université de Montréal, CRCHUM) undertook the ABLE study in critically ill patients to determine the effect of red blood cell storage on the clinical outcomes of transfusion.  The study completed in 2014 recruited a total of 2430 critically ill patients that were randomly assigned to fresh red blood cell units stored an average of six days or standard blood stored 22 days on average.  The trial hypothesis was whether fresh blood would decrease 90-day all-cause mortality.   The study concluded that transfusing fresh blood did not decrease the 90-day mortality of critically ill adults as compared to standard blood stored for three weeks. Dr. Hébert presented study findings at the 35th International Symposium on Intensive Care and Emergency Medicine in Brussels on March 17th, 2015.

Important inferences for the critical care and blood banking communities may be derived from this trial.  First, from a clinical and policy perspective, the ever increasing pressure on blood banks by clinicians requesting fresh red cells would seem unjustified in critically ill adults. Second, if true, from a basic science perspective changes noted to red-cells or the storage medium documented in many laboratory studies may have limited clinical consequences.

Click the Press Release from CRCHUM.