Role of heme in lung bacterial infection after trauma hemorrhage and stored red blood cell transfusion: A preclinical experimental study

by Brant M. Wagener, Parker J. Hu, Joo-Yeun Oh, Cilina A. Evans, Jillian R. Richter, Jaideep Honavar, Angela P. Brandon, Judy Creighton, Shannon W. Stephens, Charity Morgan, Randal O. Dull, Marisa B. Marques, Jeffrey D. Kerby, Jean-Francois Pittet, Rakesh P. Patel BackgroundTrauma is the leading cause of death and disability in patients aged 1 –46 y. Severely injured patients experience considerable blood loss and hemorrhagic shock requiring treatment with massive transfusion of red blood cells (RBCs). Preclinical and retrospective human studies in trauma patients have suggested that poorer therapeutic efficacy, increased severity of or gan injury, and increased bacterial infection are associated with transfusion of large volumes of stored RBCs, although the mechanisms are not fully understood. Methods and findingsWe developed a murine model of trauma hemorrhage (TH) followed by resuscitation with plasma and leukoreduced RBCs (in a 1:1 ratio) that were banked for 0 (fresh) or 14 (stored) days. Two days later, lungs were infected withPseudomonas aeruginosa K-strain (PAK). Resuscitation with stored RBCs significantly increased the severity of lung injury caused byP.aeruginosa, as demonstrated by higher mortality (median survival 35 h for fresh RBC group and 8 h for stored RBC group;p
Source: PLoS Medicine - Category: Internal Medicine Authors: Source Type: research