Storage duration of packed red blood cells transfused during VV ECMO is associated with elevated pulmonary artery pressure and lung injury in a sheep model

Temple FT, Simonova G, Passmore MR, Foley SR, Diab SD, Dunster KR, McDonald CI, Shekar K, Fung YL, Tung JP, Fraser JF. Critical Care DOI: 10.1186/s13054-025-05438-z

Abstract: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is associated with a high transfusion burden. While trials have concluded that red blood cell (RBC) storage does not impact patient morbidity and mortality in the critically ill or cardiac surgical cohorts, evidence is sparse for ECMO cohorts. A sheep model was to investigate this question. On an underlying injury of smoke inhalation, we compared fresh (< 5 days) or stored (35–42 days) RBC transfusion with no transfusion. Clinically relevant outcomes included pulmonary artery pressure as well as biochemical or histopathological markers of lung, liver, and renal injury.