Inhaled nitric oxide reduces adverse effects of stored blood transfusion in mice

Inhaled nitric oxide reduced the adverse effects of transfusing stored blood in mice, according to a study from the December issue of Anesthesiology. Researchers found that inhaled nitric oxide reduced tissue injury and improved short-term survival in mice that were resuscitated with a stored blood transfusion after hemorrhagic shock.

An estimated 40 percent of critically ill individuals receive at least one unit of packed red blood cells in the intensive care unit. At Massachusetts General Hospital, the average human red cell storage duration is 16 days, and many units are stored for much longer, up to 42 days.

Transfusion of blood stored for longer durations is associated with increased morbidity and mortality, especially in patients with cardiovascular disease. Stored blood cells have reduced ability to transport oxygen, and many are destroyed after transfusion causing vascular nitric oxide, an important cellular messenger, to be scavenged.

"While blood transfusions help many patients, when red cells are stored for long periods before transfusion they can make some patients sicker," said study senior author Warren M. Zapol, M.D. "Our research was modeled in mice to reproduce the adverse effects of stored blood transfusion and to learn which recipients might be more sensitive."