In vitro studies have thoroughly documented age-dependent impact of storage lesions in packed red blood cells (pRBC) on erythrocyte oxygen carrying capacity. While studies have examined the effect of pRBC age on patient outcome only few data exist on the microcirculation as their primary site of action. In this secondary analysis we examined the relationship between age of pRBC and changes of microcirculatory flow (MCF) in 54 patients based on data from the Basel Bedside assessment Microcirculation Transfusion Limit study (Ba²MiTraL) on effects of pRBC on sublingual MCF. Mean change from pre- to post-transfusion proportion of perfused vessels (∆PPV) was + 8.8% (IQR − 0.5 to 22.5), 5.5% (IQR 0.1 to 10.1), and + 4.7% (IQR − 2.1 to 6.5) after transfusion of fresh (≤ 14 days old), medium (15 to 34 days old), and old (≥ 35 days old) pRBC, respectively. Values for the microcirculatory flow index (MFI) were + 0.22 (IQR − 0.1 to 0.6), + 0.22 (IQR 0.0 to 0.3), and + 0.06 (IQR − 0.1 to 0.3) for the fresh, medium, and old pRBC age groups, respectively. Lower ∆PPV and transfusion of older blood correlated with a higher Sequential Organ Failure Assessment (SOFA) score of patients upon admission to the intensive care unit (ICU) (p = 0.01). However, regression models showed no overall significant correlation between pRBC age and ∆PPV (p = 0.2). Donor or recipient sex had no influence. We detected no significant effect of pRBC on microcirculation. Patients with a higher SOFA score upon ICU admission might experience a negative effect on the ∆PPV after transfusion of older blood.

体外研究已经彻底记录了浓缩红细胞 (pRBC) 储存损伤对红细胞携氧能力的年龄依赖性影响。虽然研究已经检查了 pRBC 年龄对患者结果的影响，但关于微循环作为其主要作用部位的数据很少。在这项二次分析中，我们根据巴塞尔床边评估微循环输血限制研究（Ba ²MiTraL) 对 pRBC 对舌下 MCF 的影响。灌注血管的输血比例 (ΔPPV) 从输血前到输血后的平均变化为 + 8.8%（IQR − 0.5 至 22.5）、5.5%（IQR 0.1 至 10.1）和 + 4.7%（IQR − 2.1 至 6.5）分别输注新鲜（≤ 14 天）、中等（15 至 34 天）和旧（≥ 35 天）pRBC。新鲜、中等和老年 pRBC 年龄组的微循环血流指数 (MFI) 值为 + 0.22（IQR − 0.1 至 0.6）、+ 0.22（IQR 0.0 至 0.3）和 + 0.06（IQR − 0.1 至 0.3） ， 分别。较低的 ΔPPV 和输注较老的血液与患者进入重症监护病房 (ICU) 时较高的序贯器官衰竭评估 (SOFA) 评分相关 (p =  0.01)。然而，回归模型显示 pRBC 年龄和 ΔPPV 之间没有总体显着相关性（p  = 0.2）。捐赠者或接受者的性别没有影响。我们检测到 pRBC 对微循环没有显着影响。入住 ICU 时 SOFA 评分较高的患者在输注较老的血液后可能会对 ΔPPV 产生负面影响。