SYSTEMATIC REVIEW article
Front. Pediatr.
Sec. Pediatric Cardiology
The Impact of Red Blood Cell Storage Duration on Clinical Outcomes in Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Yanbian University Hospital, Yanji, China
- 2Affiliated Hospital of Beihua University, Jilin, China
- 3Yanbian University Medical College, Yanji, China
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Background: The impact of red blood cell (RBC) storage duration during cardiopulmonary bypass (CPB) priming in pediatric cardiac surgery remains unclear. Objective: To evaluate whether RBC storage time affects perioperative outcomes in children undergoing cardiac surgery. Methods: We performed a systematic review and meta-analysis of studies comparing fresh versus longer-stored RBCs for CPB priming in pediatric patients. Databases searched included PubMed, EMBASE, Cochrane Library, and Web of Science (through May 2025). Primary outcomes were mortality, infection/sepsis, respiratory complications, and multiple organ dysfunction syndrome (MODS); secondary outcomes included mechanical ventilation duration, ICU stay, and intraoperative lactate levels. Results: Ten studies (including one randomized controlled trial) were included. No significant differences were found between groups in any primary or secondary outcomes, except for a slightly shorter ICU stay in the fresh RBC group (mean difference = –1.08 days), with high heterogeneity. Conclusions: RBCs stored within standard durations appear safe for CPB priming in pediatric cardiac surgery. These findings support current transfusion practices and underscore the need for further high-quality randomized trials.
Keywords: Red blood cell storage lesion, pediatric cardiac surgery, Cardiopulmonary Bypass, Blood Transfusion, Meta-analysis, Perioperative outcomes
Received: 18 Jun 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Jin, Dong, Zhang, Sun and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenzhe Jin
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