For critically ill pediatric patients, the incidence of new or progressive multiple organ dysfunction syndrome does not differ with the transfusion of fresh or standard-issue red blood cells, according to a study published in the issue of the Journal of the American Medical Association.

Philip C. Spinella, M.D., from the Washington University School of Medicine in St. Louis, and colleagues randomly assigned pediatric patients aged 3 days to 16 years to receive fresh red blood cells (768 patients) or standard-issue red blood cells (770 patients); 728 and 733 were included in the primary analysis, respectively.

The researchers found that the median storage duration was five and 18 days in the fresh and standard-issue groups, respectively (P < 0.001). No significant differences were seen in new or progressive multiple organ dysfunction syndrome between the fresh and standard-issue red blood cell groups (20.2 versus 18.2 percent; unadjusted absolute risk difference, 2.0 percent; 95 percent confidence interval, −2.0 to 6.1 percent; P = 0.33). The prevalence of sepsis was 25.8 and 25.3 percent, respectively, in the fresh and standard-issue groups, and the prevalence of acute respiratory distress syndrome was 6.6 and 4.8 percent, respectively. Intensive care unit mortality was 4.5 and 3.5 percent, respectively (P = 0.34).

"The ABC-PICU trial provides important data to support the safety of current international transfusion practice in regard to allocation of red blood cells for transfusion in critically ill children," write the authors of an accompanying editorial.

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