• Sofie L Rygård, Lars Grønlykke, Anders Perner, Per Winkel, Theis Lange, Broksø Holst Lars L Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark., Pär I Johansson, Anders Aneman, Thorsten Brodersen, Eva Laurén, Henrik Ullum, and Jørn Wetterslev.
• Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark.
• Acta Anaesthesiol Scand. 2019 Nov 1; 63 (10): 1366-1377.

BackgroundWe aimed to describe the exposure to blood transfusions and mortality among patients with septic shock.MethodsWe did a retrospective cohort study of two cohorts-patients with septic shock registered in a Danish ICU database (2008-2010) and patients from the Transfusion Requirements in Septic Shock (TRISS) trial (2011-2013). We extracted information on blood transfusions issued to all patients. We investigated the number of patients receiving very fresh blood (less than 7 days), very old blood (more than 24 days) and blood with a mixture of storage time.ResultsIn the Danish cohort, 1637 patients were included of whom 1394 (85%) received 20,239 blood units from 14 days prior the ICU admission to 90 days after; 33% were transfused before, 77% in the ICU and 36% after ICU. The exposure to exclusively very fresh or very old blood was 3% and 4%, respectively. In the TRISS cohort, 77% of the 937 patients received 5047 RBC units; 3% received exclusively very fresh and 13% very old blood. The point estimate of mortality was higher among patients receiving large amounts of exclusively very fresh and very old blood, but the number of patients were very small.ConclusionsPatients with septic shock were transfused both before and after ICU. Exposure to blood of less than 7 days or more than 24 days old were limited. We were not able to detect higher mortality among the limited number of patients with septic shock transfused with very fresh or very old blood.© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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