Trial reportPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2012
Washing red blood cells and platelets transfused in cardiac surgery reduces postoperative inflammation and number of transfusions: results of a prospective, randomized, controlled clinical trial.
Trial report in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 6 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Association between packed red blood cell transfusion and clinical deterioration in neonatal necrotizing enterocolitis: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Red blood cell transfusion management for people undergoing cardiac surgery for congenital heart disease.The Cochrane database of systematic reviews · 2025Pooled it
- What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically Ill Children and What Product Attributes Are Optimal to Guide Specific Product Selection? From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2022Pooled it
- Recommendations on RBC Transfusion in General Critically Ill Children Based on Hemoglobin and/or Physiologic Thresholds From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2018Guideline
- Washed versus unwashed red blood cells for transfusion for the prevention of morbidity and mortality in preterm infants.The Cochrane database of systematic reviews · 2016Pooled it
- Red cell transfusion management for patients undergoing cardiac surgery for congenital heart disease.The Cochrane database of systematic reviews · 2014Pooled it
- Oxidation Reduction Potential (ORP) is Predictive of Complications Following Pediatric Cardiac Surgery.Pediatric cardiology · 2018Trial
- Randomized trial of red cell washing for the prevention of transfusion-associated organ injury in cardiac surgery.British journal of anaesthesia · 2017Trial
- Longer RBC storage duration is associated with increased postoperative infections in pediatric cardiac surgery.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2015Trial
- Coming clean: should adults undergoing cardiac surgery be transfused point-of-care washed allogeneic red blood cells?Journal of thoracic disease · 2026Article
- Pre-bypass ultrafiltration reduces cytokine burden of blood prime in pediatric cardiac surgery.Scientific reports · 2025Observational
- Effect of red blood cell storage time in pediatric cardiac surgery patients: A subgroup analysis of a randomized controlled trial.JTCVS open · 2023Article
- Article
- Prophylactic Fibrinogen Reduces Excessive Bleeding in Total Hip Arthroplasty Surgery: A Randomized Double-blinded Placebo-controlled Trial.The archives of bone and joint surgery · 2023Article
- Impact of restrictive versus liberal transfusion and clinical outcomes in critically ill children: A retrospective observational study.Health science reports · 2022Article
- Tangential flow filtration facilitated washing of human red blood cells: A proof-of-concept study.Vox sanguinis · 2022Article
- Platelet transfusions in a murine model of neonatal polymicrobial sepsis: Divergent effects on inflammation and mortality.Transfusion · 2022Article
- Effect of washing units of canine red blood cells on storage lesions.Journal of veterinary internal medicine · 2022Article
- Effect of washed versus unwashed red blood cells on transfusion-related immune responses in preterm newborns.Clinical & translational immunology · 2022Article
- Bedside Allogeneic Erythrocyte Washing with a Cell Saver to Remove Cytokines, Chemokines, and Cell-derived Microvesicles.Anesthesiology · 2021Observational
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Authors and funding
15 authors.
Funding
Abstract
objectivesChildren undergoing cardiac surgery with cardiopulmonary bypass are susceptible to additional inflammatory and immunogenic insults from blood transfusions. We hypothesize that washing red blood cells and platelets transfused to these patients will reduce postoperative transfusion-related immune modulation and inflammation.
designProspective, randomized, controlled clinical trial.
settingUniversity hospital pediatric cardiac intensive care unit. PATIENTS: Children from birth to 17 yrs undergoing cardiac surgery with cardiopulmonary bypass.
interventionsChildren were randomized to an unwashed or washed red blood cells and platelet transfusion protocol for their surgery and postoperative care. All blood was leuko-reduced, irradiated, and ABO identical. Plasma was obtained for laboratory analysis preoperatively, immediately, and 6 and 12 hrs after cardiopulmonary bypass. Primary outcome was the 12-hr postcardiopulmonary bypass interleukin-6-to-interleukin-10 ratio. Secondary measures were interleukin levels, C-reactive protein, and clinical outcomes. MEASUREMENTS AND MAIN
resultsOne hundred sixty-two subjects were studied, 81 per group. Thirty-four subjects (17 per group) did not receive any blood transfusions. Storage duration of blood products was similar between groups. Among transfused subjects, the 12-hr interleukin ratio was significantly lower in the washed group (3.8 vs. 4.8; p = .04) secondary to lower interleukin-6 levels (after cardiopulmonary bypass: 65 vs.100 pg/mL, p = .06; 6 hrs: 89 vs.152 pg/mL, p = .02; 12 hrs: 84 vs.122 pg/mL, p = .09). Postoperative C-reactive protein was lower in subjects receiving washed blood (38 vs. 43 mg/L; p = .03). There was a numerical, but not statistically significant, decrease in total blood product transfusions (203 vs. 260) and mortality (2 vs. 6 deaths) in the washed group compared to the unwashed group.
conclusionsWashed blood transfusions in cardiac surgery reduced inflammatory biomarkers, number of transfusions, donor exposures, and were associated with a nonsignificant trend toward reduced mortality. A larger study powered to test for clinical outcomes is needed to determine whether these laboratory findings are clinically significant.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.