ArticleCureus2025
Effect of Red Blood Cell Storage Duration on Cerebral Blood Oxygenation in Elective Cranial Surgery: A Prospective Randomized Controlled Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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6 authors.
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Abstract
backgroundThe clinical significance of storage-related changes in packed red blood cells (PRBCs), termed "storage lesions," remains controversial. These biochemical and structural alterations may affect oxygen delivery, particularly in patients undergoing neurosurgical procedures, where cerebral oxygenation is critical. This study aimed to evaluate the effect of PRBC storage duration on cerebral oxygenation and neurological outcomes in patients undergoing elective neuro-oncological surgery.
methodsIn this prospective, double-blind, randomized controlled trial, 80 adult patients (American Society of Anesthesiologists (ASA) physical status I-II) scheduled for elective neuro-oncological surgery were enrolled and randomized into two groups: Group N (PRBCs stored <14 days) and Group O (PRBCs stored >14 days). Standard general anesthesia protocols were followed. Jugular bulb catheters were placed for serial monitoring of cerebral oxygenation parameters (saturation of jugular venous oxygen (SjvO₂), partial pressure of jugular venous oxygen (PjvO₂), lactate, and potential of hydrogen (pH)). Hemodynamic and blood gas values were recorded at baseline and hourly intraoperatively. Neurological outcomes were assessed using the Glasgow Outcome Scale-Extended (GOSE) scores at hospital discharge.
resultsDemographic characteristics, intraoperative parameters (surgery duration, blood loss), and transfusion volumes were comparable between groups. Hemodynamic variables and arterial/jugular venous blood gas measurements showed no consistent or clinically significant differences. A transient increase in SjvO₂ was observed in Group O at one hour post transfusion (p < 0.05), but this was not sustained. There were no statistically significant differences in GOSE scores or ICU and hospital stay durations between groups.
conclusionThe duration of PRBC storage did not significantly affect intraoperative cerebral oxygenation or early postoperative neurological outcomes in patients undergoing neuro-oncological surgery. These findings suggest that transfusion of older PRBCs (>14 days) is clinically safe in this setting.
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