CHEST Giora Netzer, MD, MSCE, FCCP; Chirag V. Shah, MD; Theodore J. Iwashyna, MD, Ph D; Paul N. Lanken, MD, FCCP; Barbara Finkel, MSN; Barry Fuchs, MD, FCCP; Wensheng Guo, PhD; And Jason D. Christie, MD, MSCE (RBC) RBC (ALI) 248 ALIRBC 39.5% 248 207 (83.5%) 1U RBC RBC ( OR 3.12 95%CI 1.28 7.58 P 0.001) RBC OR 1.06 (95%CI 1.04 1.09 P 0.001) ALI RBC OR (1.13 95%CI 1.07 1.20 P 0.001) ALI RBC RBCOR 1.14 (95%CI 1.07 1.21 P 0.001) RBC OR 1.06 (95%CI 1.03 1.09 P 0.001) ALI RBC ALI RBC RBCRBC ALI (blood component transfusion); (blood transfusion); (mortality); (adult respiratory distress syndrome) ALI = acute lung injury; APACHE = acute physiology and chronic health evaluation; ARMA = Acute Respiratory Distress Syndrome Network Low Tidal Volume; CI = confidence interval; OR = odds ratio; TRALI = transfusion-related lung injury 148
(ALI) (ARDS) ALI / ARDS 1.5 8.3 / 100 000 [1 4] ALI / ARDS 306 / 100 000 ( ) 40% [5] ALI 74 500 3600000d [4] [28 30] 10 y [31] ALI / ARDS RBC ALI / ARDS 20 ALI / ARDS [6 7] [8 23] [24 26] ALI / ARDS ALI / ARDS ALI / ARDS [27] From the Division of Pulmonary and Critical Care (Dr. Netzer), University of Maryland School of Medicine, Baltimore, MD; Division of Pulmonary, Allergy and Critical Care (Drs. Shah, Iwashyna, Lanken, Finkel, Fuchs, and Christie), Hospital of the University of Pennsylvania, Philadelphia, PA; and Center for Clinical Epidemiology and Biostatistics (Dr. Guo), University of Pennsylvania School of Medicine, Philadelphia, PA. This research was supported in part by National Institutes of Health National Heart, Lung, and Blood Institute grant P01- HL79063. Correspondence to: Giora Netzer, MD, MSCE, FCCP, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, MSTF Bldg, Room 800, 685 W Baltimore St,Baltimore, MD 21201; e-mail: gnetzer@medicine. umaryland.edu 248 1999 2002 ALI / ARDS ALI / ARDS (NHLBISCR) ALI / ARDS ICU 13 ALI / ARDS ARDS [32] ALI / ARDS 48 h ALI / ARDS 30% RBC () ( RBC ) RBC [33 34] [35] ARDS www.chestjournal.org.cn CHEST 2008 3 5 3 149
(2000 5 4 ) [36] 365 d 1 RBC RBC logistic 1 ALI (1) (n =150) (n =98) P / 45.2 19.0 53.9 17.1 0.001 92 (61) 64 (65) 0.527 51 (34) 16 (16) 0.002 APACHE 59.5 20.7 80.5 28.0 0.001 ICU /d 20.3 17.3 12.6 12.9 0.001 /d 35.6 25.8 17.2 17.5 0.001 17 (11) 25 (26) 0.004 16 (11) 21 (22) 0.020 (1) x _ s (%) ALI / ARDS ALI / ARDS ALI / ARDS RBC logistic ALI / ARDS 1 ALI [37 39] RBC logistic RBC RBC OR 15% [40] (STATA v.9 StataCorp LP College Station TX) 1999 2002 262 7 6 1 248 1 39.5% ( 53.9 45.2 P 0.00 1) APACHE ( ) ( 80.5 59.5 P 0.001) ( 26% 11% P =0.004) ( 22% 11% P = 0.020) ALI ( 16% 34% P =0.002) RBC ( 92% 78% P = 0.004) ( 56% 41% P =0.017) RBC OR 3 Pao 2 / 200 OR 15% OR APACHE ( 2) APACHE 150
3 RBC OR RBC RBC RBC ( 1U) OR 2.90 (95%CI 1.32 6.35 P = 0.008) logistic APACHE OR (3.12 95%CI 1.28 7.58 P =0.012) RBCRBC logistic OR (95%CI) P 1.05 (1.02 1.07) 0.001 1.05 (1.03 1.08) 0.001 1.05 (1.03 1.08) 0.001 1.05 (1.03 1.08) 0.001 APACHE 1.06 (1.03 1.09) 0.001 APACHE 1.06 (1.04 1.09) 0.001 APACHE 2 RBC OR logistic OR (95% CI) P 1.06 (1.04 1.09) 0.001 ( ) 1.06 (1.04 1.09) 0.001 1.06 (1.04 1.09) 0.001 1.07 (1.04 1.10) 0.001 1.06 (1.04 1.09) 0.001 1.06 (1.03 1.09) 0.001 1.06 (1.04 1.09) 0.001 APACHE RBC RBC 1.05 (95%CI 1.02 1.07 P 0.001) 1.06 (95%CI 1.04 1.09 P 0.001) ( 3) (ARMA) 365 d ARMA ( ) ALIRBC logistic ALI OR 1.13 (95%CI 1.07 1.29 P 0.001) ALI ( 4) ALI ALI www.chestjournal.org.cn CHEST 2008 3 5 3 151
21 ALI / ARDS 45 RBC OR 15% RBC OR RBC OR RBC OR RBCOR 1.10 (95%CI 1.05 1.16 P 0.001) 1.14 (95%CI 1.07 1.21 P 0.001) RBC RBC OR 1.04 (95%CI 1.01 1.07 P = 0.007) 1.06 (95%CI 1.03 1.09 P 0.001) ( 5) 4 RBC OR 5 RBC OR logistic OR (95% CI) P 1.09 (1.04 1.14) 0.001 1.10 (1.05 1.16) 0.001 RBC 1.14 (1.07 1.21) 0.001 RBC APACHE 1.03 (1.00 1.05) 0.039 1.04 (1.01 1.07) 0.007 RBC 1.06 (1.02 1.09) 0.001 RBC APACHE ALI RBC RBC ( 6) logistic OR (95% CI) P ALI 1.02 (0.98 1.06) 0.430 ALI 1.00 (0.96 1.04) 0.899 RBC ALI 1.01 (0.97 1.06) 0.615 RBC APACHE ALI 1.10 (1.05 1.16) 0.001 ALI 1.11 (1.05 1.16) 0.001 RBC ALI 1.13 (1.07 1.20) 0.001 RBC APACHE ALI / ARDS RBC ALI / ARDS RBC RBC RBC OR RBC [8 11 12 21 22 27] OR 1.06 4U RBC OR 152
24% Gong [27] ALI / ARDS ALI / ARDS RBC ALI / ARDS ALI / ARDS [41] CD4 α 2 γ [42 49] RBC E 1 [50 53] RBC [54 56] OR [57 60] 6 OR logistic OR (95% CI) P 1.10 (1.04 1.16) 0.001 1.10 (1.04 1.16) 0.002 1.06 (1.00 1.13) 0.037 APACHE 1.07 (1.01 1.14) 0.022 APACHE 1.01 (0.95 1.07) 0.782 APACHE RBC RBC ARMA [36] OR ALI / ARDS OR ALI / ARDS [61 62] Rivers [63] [64] ALI / ARDS ALI / ARDS [46] RBC ALI / ARDS ALI / ARDS ( 7g / dl) [29] ALI / ARDS [65] ALI / ARDS RBC RBC RBC [66] RBC RBC www.chestjournal.org.cn CHEST 2008 3 5 3 153
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