Cardiothoracic & vascular anesthesia
Impact of Point-of-care Allogeneic Red Blood Cell Washing on Markers of Transfusion-related Respiratory Complications: A Phase II Randomized Clinical Trial
Authors' conclusion
Among patients undergoing cardiovascular surgery with high risk of erythrocyte transfusion, point-of-care washing of allogeneic erythrocyte transfusions did not mitigate changes in intermediate markers of lung injury or cardiopulmonary physiologic responses to erythrocyte transfusion and was not associated with improved clinical outcomes.
Study context
- Population
- Patients undergoing cardiac surgery with high risk of erythrocyte transfusionanalysed
- Participants
- 154 patients
- Comparison
- Washed vs Standard issue
- Washedn = 81
- Standard issuen = 73reference
- Primary endpoint
- Changes in intermediate markers of lung injury and cardiopulmonary physiologic responses to RBC transfusion
Methodological detailsphase II, two-centre, nonblinded, modified intention-to-treat
- Phase II
- Two-centre
- Nonblinded
- Modified intention-to-treat
Primary result
As reported in the abstract
Recipient lung injury biomarkers
- No between-group differences in any assessed recipient lung injury biomarker (all P values > adjusted alpha)
- Modified intention-to-treat
Secondary outcomes
Median
| Outcome | Washed | Standard issue | P value |
|---|---|---|---|
| Allogeneic erythrocyte units transfused on day of surgery | 3.0 (IQR 2.0–5.0) | 3.0 (IQR 2.0–4.0) | P = 0.13 |
ICU stay
- Similar, washed vs standard issue, median [IQR]
- 3.0 [2.0 to 5.0] vs. 3.0 [2.0 to 4.0] days; P = 0.117
Hospital LOS
- Similar, washed vs standard issue, median [IQR]
- 12.0 [9.0 to 17.0] vs. 12.0 [9.0 to 17.0] days; P = 0.801
Ventilator-free days · day 28
- Similar, washed vs standard issue, median [IQR]
- 27.0 [27.0 to 27.0] vs. 27.0 [26.0 to 27.0]; P = 0.699
Oxygen-free days · day 28
- Similar, washed vs standard issue, median [IQR]
- 24.0 [19.0 to 26.0] vs. 24.0 [22.0 to 26.0]; P = 0.400
Mortality, transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO) and AKI
- No significant differences in mortality rate or incidence of TRALI, TACO and AKI
Safety
- No significant difference in incidence of AKI
Original publication
Impact of Point-of-care Allogeneic Red Blood Cell Washing on Markers of Transfusion-related Respiratory Complications: A Phase II Randomized Clinical Trial. Anesthesiology. Published 14 April 2025. doi:10.
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