red blood cell transfusion and increased length of storage are not associated with deep vein thrombosis in medical and surgical critically ill patients a prospective observational cohort study红细胞输血和增加长度的存储与深静脉血栓形成在医学和外科危重患者前瞻性观察性队列研究.pdfVIP

Katsios et al. Critical Care 2011, 15:R263 /content/15/6/R263 RESEARCH Open Access Red blood cell transfusion and increased length of storage are not associated with deep vein thrombosis in medical and surgical critically ill patients: a prospective observational cohort study 1 1 2 3 1 4 Christina Katsios , Lauren Griffith , Philip Spinella , Jacques Lacroix , Mark Crowther , Paul Hebert , 1 5 1 1* Maureen Meade , William Geerts , Christian Rabbat and Deborah Cook Abstract Introduction: With prolonged storage times, cell membranes of red blood cells (RBCs) undergo morphologic and biochemical changes, termed ‘RBC storage lesions’. Storage lesions may promote inflammation and thrombophilia when transfused. In trauma patients, RBC transfusion was an independent risk factor for deep vein thrombosis (DVT), specifically when RBC units were stored 21 days or when 5 or more units were transfused. The objective of this study was to determine if RBC transfusions or RBC storage age predicts incident DVT in medical or surgical intensive care unit (ICU) patients. Methods: Using a database which prospectively enrolled 261 patients over the course of 1 year with an ICU stay of at least 3 days, we analyzed DVT and RBC transfusions using Cox proportional hazards regression. Transfusions were analyzed with 4 thresholds, and storage age using 3 thresholds. DVTs were identified by twice-weekly proximal leg ultrasounds. Multivariable analyses were adjusted for 4 significant DVT predictors in this population (venous thrombosis history, chronic dialysis, platelet transfusion and inotropes). Results: Of 261 patients, 126 (48.3%) h