The analysis showed that 11 percent of patients died, while 57 patients (13.5 percent) developed NOSO: 32 patients developed one NOSO, 21 developed two NOSO, and 4 developed 3 NOSO. Patients who developed NOSO had a significantly higher OL (28.5 days vs. 32 days), and a significantly greater number of units of blood (2 U vs. 3 U). Patients who received transfusions with blood that was 29 days or older were twice as likely to develop NOSO as those receiving transfusions with blood stored for 28 days or less. When the outcome of "at least one infection" was analyzed, a higher number of units of blood (>5 U) was found to be an independent predictor of infection. Furthermore, while the age of the first unit of blood transfused appeared to be associated with the development of infection, the age of the oldest unit showed the strongest relationship.
Many institutions, including Dr. Nahra's, use the oldest available blood first, to ensure that it does not go to waste. Researchers speculate that if strict regulation of blood storage were to occur (ie, shorter maximum storage allowance), the overall blood supply may decrease.
"More cautious utilization of blood might help to alleviate, at in least part, a diminished blood supply that might result from such a change in policy," said study director and senior investigator David Gerber, DO, Cooper University Hospital. "More studies are needed, and the overall implications of any such potential changes need to be formally assessed before any major changes in blood storage policy can be proposed."
"The results of this study raise questions about current blood storage standards and transfusion practices and suggest additional research is needed in these areas," said James A. L. Mathers, Jr., MD, FCCP, President of the American College of Chest Physicians.
CHEST 2008 is the 74th
|SOURCE American College of Chest Physicians|
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