Trial reportCritical care (London, England)2014
Microcirculatory effects of the transfusion of leukodepleted or non-leukodepleted red blood cells in patients with sepsis: a pilot study.
Trial report in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01584999 (Effects on the Septic Patient's Microcirculation of the Transfusion of Three Different Types of Concentrated Red Blood Cells.), which is not on this map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Effects on the Septic Patient's Microcirculation of the Transfusion of Three Different Types of Concentrated Red Blood Cells.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Leukoreduction for the prevention of adverse reactions from allogeneic blood transfusion.The Cochrane database of systematic reviews · 2015Pooled it
- Impact of red blood cell transfusion on oxygen transport and metabolism in patients with sepsis and septic shock: a systematic review and meta-analysis.Revista Brasileira de terapia intensivaPooled it
- Optimal hemoglobin threshold for blood transfusions in sepsis and septic shock: a retrospective analysis.Internal and emergency medicine · 2025Trial
- The impact of red blood cell storage duration on tissue oxygenation in cardiac surgery.The Journal of thoracic and cardiovascular surgery · 2017Trial
- Plasma free hemoglobin and microcirculatory response to fresh or old blood transfusions in sepsis.PloS one · 2015Trial
- Novelties in the evaluation of microcirculation in septic shock.Journal of intensive medicine · 2023Review
- Identifying a sublingual triangle as the ideal site for assessment of sublingual microcirculation.Journal of clinical monitoring and computing · 2023Article
- Microcirculation-guided resuscitation in sepsis: the next frontier?Frontiers in medicine · 2023Review
- Effects of Fluids on the Sublingual Microcirculation in Sepsis.Journal of clinical medicine · 2022Review
- Links between Endothelial Glycocalyx Changes and Microcirculatory Parameters in Septic Patients.Life (Basel, Switzerland) · 2021Article
- Decreased endothelial glycocalyx thickness is an early predictor of mortality in sepsis.Anaesthesia and intensive care · 2020Article
- Sublingual microcirculation does not reflect red blood cell transfusion thresholds in the intensive care unit-a prospective observational study in the intensive care unit.Critical care (London, England) · 2020Observational
- Exploring the microvascular impact of red blood cell transfusion in intensive care unit patients.Critical care (London, England) · 2019Observational
- Association of sublingual microcirculation parameters and endothelial glycocalyx dimensions in resuscitated sepsis.Critical care (London, England) · 2019Observational
- The glycocalyx: a novel diagnostic and therapeutic target in sepsis.Critical care (London, England) · 2019Review
- Observational
- Bedside analysis of the sublingual microvascular glycocalyx in the emergency room and intensive care unit - the GlycoNurse study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Observational
- Transfusion Decision Making in Pediatric Critical Illness.Pediatric clinics of North America · 2017Review
- Impact of microcirculatory video quality on the evaluation of sublingual microcirculation in critically ill patients.Journal of clinical monitoring and computing · 2017Article
- Transfusion of Red Blood Cells to Patients with Sepsis.International journal of molecular sciences · 2017Review
Corrections and comments
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Authors and funding
15 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMicrovascular alterations impair tissue oxygenation during sepsis. A red blood cell (RBC) transfusion increases oxygen (O2) delivery but rarely improves tissue O2 uptake in patients with sepsis. Possible causes include RBC alterations due to prolonged storage or residual leukocyte-derived inflammatory mediators. The aim of this study was to compare the effects of two types of transfused RBCs on microcirculation in patients with sepsis.
methodsIn a prospective randomized trial, 20 patients with sepsis were divided into two separate groups and received either non-leukodepleted (n = 10) or leukodepleted (n = 10) RBC transfusions. Microvascular density and perfusion were assessed with sidestream dark field (SDF) imaging sublingually, before and 1 hour after transfusions. Thenar tissue O2 saturation (StO2) and tissue hemoglobin index (THI) were determined with near-infrared spectroscopy, and a vascular occlusion test was performed. The microcirculatory perfused boundary region was assessed in SDF images as an index of glycocalyx damage, and glycocalyx compounds (syndecan-1, hyaluronan, and heparan sulfate) were measured in the serum.
resultsNo differences were observed in microvascular parameters at baseline and after transfusion between the groups, except for the proportion of perfused vessels (PPV) and blood flow velocity, which were higher after transfusion in the leukodepleted group. Microvascular flow index in small vessels (MFI) and blood flow velocity exhibited different responses to transfusion between the two groups (P = 0.03 and P = 0.04, respectively), with a positive effect of leukodepleted RBCs. When within-group changes were examined, microcirculatory improvement was observed only in patients who received leukodepleted RBC transfusion as suggested by the increase in De Backer score (P = 0.02), perfused vessel density (P = 0.04), PPV (P = 0.01), and MFI (P = 0.04). Blood flow velocity decreased in the non-leukodepleted group (P = 0.03). THI and StO2 upslope increased in both groups. StO2 and StO2 downslope increased in patients who received non-leukodepleted RBC transfusions. Syndecan-1 increased after the transfusion of non-leukodepleted RBCs (P = 0.03).
conclusionsThis study does not show a clear superiority of leukodepleted over non-leukodepleted RBC transfusions on microvascular perfusion in patients with sepsis, although it suggests a more favorable effect of leukodepleted RBCs on microcirculatory convective flow. Further studies are needed to confirm these findings.
trial registrationClinicalTrials.gov, NCT01584999.
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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.