Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells
BACKGROUND: Various bioactive substances are released from white cell (WBC) granules into red cell (RBC) components in a time‐dependent manner during blood storage. Some of these substances may have immunosuppressive effects and may contribute to transfusion‐induced immunomodulation. RBCs transfused...
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| Veröffentlicht in: | Transfusion (Philadelphia, Pa.) Pa.), 1999-07, Vol.39 (7), p.701-710 |
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| description | BACKGROUND: Various bioactive substances are released from white cell (WBC) granules into red cell (RBC) components in a time‐dependent manner during blood storage. Some of these substances may have immunosuppressive effects and may contribute to transfusion‐induced immunomodulation. RBCs transfused after prolonged storage may be associated with a higher incidence of postoperative infections than fresh RBCs. This hypothesis does not seem to have been investigated in a clinical study.
STUDY DESIGN AND METHODS: The records of 416 consecutive patients undergoing coronary artery bypass graft operations at the Massachusetts General Hospital were reviewed. The association between the length of storage of the transfused RBCs, as well as the number of units of non‐WBC‐reduced allogeneic RBCs and/or platelets transfused, and the occurrence of postoperative pneumonia was calculated by logistic regression analyses adjusting for the effects of confounding factors. Among these were the numbers of days of intubation, days of impaired consciousness, and units of RBCs transfused.
RESULTS: By Centers for Disease Control and Prevention criteria, pneumonia developed in 54 patients (13.0%). Among 269 patients given RBCs, the risk of pneumonia increased by 1 percent per day of increase in the mean storage time of the transfused RBCs (p |
| doi_str_mv | 10.1046/j.1537-2995.1999.39070701.x |
| format | Article |
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STUDY DESIGN AND METHODS: The records of 416 consecutive patients undergoing coronary artery bypass graft operations at the Massachusetts General Hospital were reviewed. The association between the length of storage of the transfused RBCs, as well as the number of units of non‐WBC‐reduced allogeneic RBCs and/or platelets transfused, and the occurrence of postoperative pneumonia was calculated by logistic regression analyses adjusting for the effects of confounding factors. Among these were the numbers of days of intubation, days of impaired consciousness, and units of RBCs transfused.
RESULTS: By Centers for Disease Control and Prevention criteria, pneumonia developed in 54 patients (13.0%). Among 269 patients given RBCs, the risk of pneumonia increased by 1 percent per day of increase in the mean storage time of the transfused RBCs (p<0.005). In an analysis of all patients, the risk of pneumonia increased by 5 percent per unit of non‐WBC‐reduced allogeneic RBCs and/or platelets received (p = 0.0584).
CONCLUSION: After adjustment for the effects of the risk factors for pneumonia and the number of transfused RBCs, an association was observed between the length of storage of transfused RBCs and the development of postoperative pneumonia. This association should be investigated further in future studies of the outcomes of blood transfusion.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1046/j.1537-2995.1999.39070701.x</identifier><identifier>PMID: 10413277</identifier><identifier>CODEN: TRANAT</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Inc</publisher><subject>Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Preservation ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; CABG = coronary artery bypass graft ; Coronary Artery Bypass - adverse effects ; Erythrocyte Transfusion ; Erythrocytes ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Pneumonia - etiology ; Postoperative Period ; RBC(s) = red cell(s) ; RCT(s) randomized controlled trials ; Risk Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Surgical Wound Infection - etiology ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; UTI(s) = urinary tract infection(s) ; WBC(s) = white cells</subject><ispartof>Transfusion (Philadelphia, Pa.), 1999-07, Vol.39 (7), p.701-710</ispartof><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5111-30073fcb6fa3b4bd602db355fa81f8ecd7662db75fcaa3d3b92d26ce6c3826b63</citedby><cites>FETCH-LOGICAL-c5111-30073fcb6fa3b4bd602db355fa81f8ecd7662db75fcaa3d3b92d26ce6c3826b63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1537-2995.1999.39070701.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1537-2995.1999.39070701.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1866485$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10413277$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vamvakas, E.C.</creatorcontrib><creatorcontrib>Carven, J.H.</creatorcontrib><title>Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells</title><title>Transfusion (Philadelphia, Pa.)</title><addtitle>Transfusion</addtitle><description>BACKGROUND: Various bioactive substances are released from white cell (WBC) granules into red cell (RBC) components in a time‐dependent manner during blood storage. Some of these substances may have immunosuppressive effects and may contribute to transfusion‐induced immunomodulation. RBCs transfused after prolonged storage may be associated with a higher incidence of postoperative infections than fresh RBCs. This hypothesis does not seem to have been investigated in a clinical study.
STUDY DESIGN AND METHODS: The records of 416 consecutive patients undergoing coronary artery bypass graft operations at the Massachusetts General Hospital were reviewed. The association between the length of storage of the transfused RBCs, as well as the number of units of non‐WBC‐reduced allogeneic RBCs and/or platelets transfused, and the occurrence of postoperative pneumonia was calculated by logistic regression analyses adjusting for the effects of confounding factors. Among these were the numbers of days of intubation, days of impaired consciousness, and units of RBCs transfused.
RESULTS: By Centers for Disease Control and Prevention criteria, pneumonia developed in 54 patients (13.0%). Among 269 patients given RBCs, the risk of pneumonia increased by 1 percent per day of increase in the mean storage time of the transfused RBCs (p<0.005). In an analysis of all patients, the risk of pneumonia increased by 5 percent per unit of non‐WBC‐reduced allogeneic RBCs and/or platelets received (p = 0.0584).
CONCLUSION: After adjustment for the effects of the risk factors for pneumonia and the number of transfused RBCs, an association was observed between the length of storage of transfused RBCs and the development of postoperative pneumonia. This association should be investigated further in future studies of the outcomes of blood transfusion.</description><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Preservation</subject><subject>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</subject><subject>CABG = coronary artery bypass graft</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Erythrocyte Transfusion</subject><subject>Erythrocytes</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumonia - etiology</subject><subject>Postoperative Period</subject><subject>RBC(s) = red cell(s)</subject><subject>RCT(s) randomized controlled trials</subject><subject>Risk Factors</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Surgical Wound Infection - etiology</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>UTI(s) = urinary tract infection(s)</subject><subject>WBC(s) = white cells</subject><issn>0041-1132</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVUcFu1DAQtRCILoVfQJZA3BLseOPEcEKFbSkVSGhRJS6W44y3XrJ2sBPY_QM-G4dsC1dkjUYz8-bN-A1CzyjJKVnyl9uclqzKCiHKnAohciZIlR7N9_fQ4q52Hy0IWdKMUlacoEcxbgkhhSD0ITpJPClbVQv0ax2Ui2aM1jusXIt7HwffQ1CD_QG4dzDuvLMKW4e1D96pcMAqDJBcc-hVjHgTlBlwHMMmJV9hMAb0gL3Bww3gDtxmuJmiRBvUBv4UjjOhxSGZhq6Lj9EDo7oIT47-FH1ZvVufXWRXn87fn725ynRJKc0YIRUzuuFGsWbZtJwUbcPK0qiamhp0W3GeMlVptFKsZY0o2oJr4JrVBW84O0UvZt4--O8jxEHubJw2UA78GCUXSaKkTQK-noE6-BgDGNkHu0vfl5TI6RByKyex5SS2nA4hbw8h96n76XHM2Oyg_ad3Vj4Bnh8BKmrVmSSJtvEvruZ8WZcJ9naG_bQdHP5nBbn-vLqNEk0209g4wP6ORoVvklesKuX1x3P59fJyfVFcf5Ar9huBZriw</recordid><startdate>199907</startdate><enddate>199907</enddate><creator>Vamvakas, E.C.</creator><creator>Carven, J.H.</creator><general>Blackwell Science Inc</general><general>Blackwell Publishing</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199907</creationdate><title>Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells</title><author>Vamvakas, E.C. ; Carven, J.H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5111-30073fcb6fa3b4bd602db355fa81f8ecd7662db75fcaa3d3b92d26ce6c3826b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Preservation</topic><topic>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</topic><topic>CABG = coronary artery bypass graft</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Erythrocyte Transfusion</topic><topic>Erythrocytes</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumonia - etiology</topic><topic>Postoperative Period</topic><topic>RBC(s) = red cell(s)</topic><topic>RCT(s) randomized controlled trials</topic><topic>Risk Factors</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Surgical Wound Infection - etiology</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>UTI(s) = urinary tract infection(s)</topic><topic>WBC(s) = white cells</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vamvakas, E.C.</creatorcontrib><creatorcontrib>Carven, J.H.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vamvakas, E.C.</au><au>Carven, J.H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>1999-07</date><risdate>1999</risdate><volume>39</volume><issue>7</issue><spage>701</spage><epage>710</epage><pages>701-710</pages><issn>0041-1132</issn><eissn>1537-2995</eissn><coden>TRANAT</coden><abstract>BACKGROUND: Various bioactive substances are released from white cell (WBC) granules into red cell (RBC) components in a time‐dependent manner during blood storage. Some of these substances may have immunosuppressive effects and may contribute to transfusion‐induced immunomodulation. RBCs transfused after prolonged storage may be associated with a higher incidence of postoperative infections than fresh RBCs. This hypothesis does not seem to have been investigated in a clinical study.
STUDY DESIGN AND METHODS: The records of 416 consecutive patients undergoing coronary artery bypass graft operations at the Massachusetts General Hospital were reviewed. The association between the length of storage of the transfused RBCs, as well as the number of units of non‐WBC‐reduced allogeneic RBCs and/or platelets transfused, and the occurrence of postoperative pneumonia was calculated by logistic regression analyses adjusting for the effects of confounding factors. Among these were the numbers of days of intubation, days of impaired consciousness, and units of RBCs transfused.
RESULTS: By Centers for Disease Control and Prevention criteria, pneumonia developed in 54 patients (13.0%). Among 269 patients given RBCs, the risk of pneumonia increased by 1 percent per day of increase in the mean storage time of the transfused RBCs (p<0.005). In an analysis of all patients, the risk of pneumonia increased by 5 percent per unit of non‐WBC‐reduced allogeneic RBCs and/or platelets received (p = 0.0584).
CONCLUSION: After adjustment for the effects of the risk factors for pneumonia and the number of transfused RBCs, an association was observed between the length of storage of transfused RBCs and the development of postoperative pneumonia. This association should be investigated further in future studies of the outcomes of blood transfusion.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Inc</pub><pmid>10413277</pmid><doi>10.1046/j.1537-2995.1999.39070701.x</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Preservation Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis CABG = coronary artery bypass graft Coronary Artery Bypass - adverse effects Erythrocyte Transfusion Erythrocytes Female Humans Male Medical sciences Middle Aged Pneumonia - etiology Postoperative Period RBC(s) = red cell(s) RCT(s) randomized controlled trials Risk Factors Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Surgical Wound Infection - etiology Transfusions. Complications. Transfusion reactions. Cell and gene therapy UTI(s) = urinary tract infection(s) WBC(s) = white cells |
| title | Transfusion and postoperative pneumonia in coronary artery bypass graft surgery: effect of the length of storage of transfused red cells |
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