Blood transfusion is a common requirement in the intensive care setting. Improved tissue oxygenation is the therapeutic objective of transfusion for normovolaemic anaemia. However, the efficiency with which red blood cells (RBCs) carry oxygen to the tissues has been questioned, particularly after prolonged storage. We measured the impact on oxygen transport variables (base excess, lactate and ScvO2) of transfusion of a unit of stored RBCs in 45 critically ill adults. There were no significant changes in these variables, except for ScvO2, which increased with older units (≥ 20 days storage), suggesting impaired oxygen uptake by the tissues. The role of the storage lesion (structural and functional changes in the RBC acquired in storage media) is discussed with reference to its impact on oxygen delivery.
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