Abstract：
OBJECTIVE: The aim of this work was to resolve the uncertainty of whether transfusion of fresher red blood cells (RBCs) is better or not with regard to the safety and efficacy.
METHODS: This systematic review was performed in accordance with our protocol registered on PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022379183).
RESULTS: After a literature search, 13,247 records were identified, and 26 randomized controlled trials (RCTs) involving 53,859 participants were eligible and included in this review. The results in our review suggested that there was no significant effect of fresher vs older RBCs on mortality (relative risk [RR] = 1.04; 95% CI, 0.99-1.09; P = .39; I2 = 0%), transfusion reactions (RR = 0.87; 95% CI, 0.57-1.33; P = .64; I2 = 0%). However, the transfusion of fresher RBCs might increase the risk of nosocomial infection (RR = 1.11; 95% CI, 1.02-1.20; P = .02; I2 = 0%), whereas there was no significant difference in the fresh vs old subgroup (RR = 0.87; 95% CI, 0.68 to 1.12; P = .28; I2 = 0%).
CONCLUSIONS: Our study updated and reinforced the evidence of previously published systematic reviews that support the safety and efficiency of current practice of issuing the oldest available RBCs in the blood bank inventory.
METHODS: This systematic review was performed in accordance with our protocol registered on PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022379183).
RESULTS: After a literature search, 13,247 records were identified, and 26 randomized controlled trials (RCTs) involving 53,859 participants were eligible and included in this review. The results in our review suggested that there was no significant effect of fresher vs older RBCs on mortality (relative risk [RR] = 1.04; 95% CI, 0.99-1.09; P = .39; I2 = 0%), transfusion reactions (RR = 0.87; 95% CI, 0.57-1.33; P = .64; I2 = 0%). However, the transfusion of fresher RBCs might increase the risk of nosocomial infection (RR = 1.11; 95% CI, 1.02-1.20; P = .02; I2 = 0%), whereas there was no significant difference in the fresh vs old subgroup (RR = 0.87; 95% CI, 0.68 to 1.12; P = .28; I2 = 0%).
CONCLUSIONS: Our study updated and reinforced the evidence of previously published systematic reviews that support the safety and efficiency of current practice of issuing the oldest available RBCs in the blood bank inventory.
摘要：
目的：这项工作的目的是解决输注新鲜红细胞（RBC）的安全性和有效性是否更好的不确定性。
方法：根据我们在PROSPERO上注册的协议（https：//www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022379183)。
结果：经过文献检索，确定了13247条记录，纳入53,859名参与者的26项随机对照试验(RCTs)纳入本综述.我们的综述结果表明，新鲜的红细胞与较旧的红细胞对死亡率没有显着影响（相对风险[RR]=1.04;95％CI，0.99-1.09;P=.39;I2=0％），输血反应（RR=0.87；95%CI，0.57-1.33；P=.64；I2=0%）。然而,输注更新鲜的红细胞可能会增加医院感染的风险（RR=1.11;95％CI，1.02-1.20;P=.02;I2=0％），而新鲜亚组与老年亚组之间没有显着差异（RR=0.87；95％CI，0.68至1.12；P=.28；I2=0％）。
结论：我们的研究更新并加强了以前发表的系统评价的证据，这些系统评价支持当前在血库库存中发放最古老的可用红细胞的做法的安全性和有效性。
方法：根据我们在PROSPERO上注册的协议（https：//www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022379183)。
结果：经过文献检索，确定了13247条记录，纳入53,859名参与者的26项随机对照试验(RCTs)纳入本综述.我们的综述结果表明，新鲜的红细胞与较旧的红细胞对死亡率没有显着影响（相对风险[RR]=1.04;95％CI，0.99-1.09;P=.39;I2=0％），输血反应（RR=0.87；95%CI，0.57-1.33；P=.64；I2=0%）。然而,输注更新鲜的红细胞可能会增加医院感染的风险（RR=1.11;95％CI，1.02-1.20;P=.02;I2=0％），而新鲜亚组与老年亚组之间没有显着差异（RR=0.87；95％CI，0.68至1.12；P=.28；I2=0％）。
结论：我们的研究更新并加强了以前发表的系统评价的证据，这些系统评价支持当前在血库库存中发放最古老的可用红细胞的做法的安全性和有效性。
