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

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⁺, Ca²⁺, 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.