Among children with lactic acidosis due to severe anemia, transfusion of longer-storage compared with shorter-storage RBC units did not result in inferior reduction of elevated blood lactate levels, according to a study of 290 children aged 6 to 60 months, most with malaria or sickle cell disease. Researchers found:

• Mean presenting hemoglobin level was 3.7 g/dL and mean lactate level was 9.3 mmol/L.

• Mean RBC unit storage was 8 days for shorter storage and 32 days for longer storage.

• The proportion achieving the primary endpoint was 0.61 in the longer storage group vs 0.58 in the shorter storage group.

• Mean lactate levels were not significantly different between the 2 groups at 0, 2, 4, 6, 8, or 24 hours.

• Lactate reduction, clinical assessment, cerebral oxygen saturation, electrolyte abnormalities, adverse events, survival, and 30-day recovery were not significantly different between groups.

Citation: Dhabangi A, Ainomugisha B, Cserti-Gazdewich C, et al. Effect of transfusion of red blood cells with longer vs shorter storage duration on elevated blood lactate levels in children with severe anemia. [Published online ahead of print December 5, 2015]. JAMA. doi: 10.1001/jama.2015.13977.