Differential analysis on effect of red blood cell storage duration on serum interleukin-6 level in low brith weight premature infants

Chen Sitian; Li Zhengqiu; Li Sai; Mo Yi; Liu Jianlong

doi:10.3969/j.issn.1674-7151.2025.03.016

Abstract：Objective To investigate the transfusion effects of red blood cells(RBCs)with different storage time on serum interleukin-6(IL-6)in low birth weight preterm infants and analyze the relationship between RBC storage time and proinflammatory responses.Methods A retrospective cohort study was conducted,the 75 preterm infants(gestational age<37 weeks)admitted to Neonatal Intensive Care Unit(NICU)of Hunan Children's Hospital from January 2020 to July 2022 were included.The infants were divided into≤14 days group(45 cases)and≥21 days group(30 cases)according to different RBC storage time.The clinical data and laboratory indexes[IL-6,C-reactive protein(CRP),hemoglobin(Hb)and white blood cell count(WBC)]were collected before and 24 hours after blood transfusion.The differences in above indexes between two groups were compared,and multivariate regression was used to analyze the association between RBC storage time and changes of IL-6 level.Results At 24 hours after blood transfusion,the≤14 days group showed a decrease in IL-6 level by(5.2±3.6)mmol/L,while the≥21 days group exhibited an increase of(19.9±14.0)mmol/L,with statistically significant difference(P<0.05).Multivariate regression analysis revealed that RBC storage time≥21 days(P=0.02)and lower 5 minute Apgar score(P=0.02)were independent risk factors for elevated IL-6 level after blood transfusion.No significant differences were observed in Hb,WBC and CRP levels between two groups.Conclusions Transfusion of RBCs stored for≥21 days significantly increases serum IL-6 level in low birth weight preterm infants,suggesting that prolonged storage may induce stronger proinflammatory responses.Preferential use of shorter-storage RBCs is recommended for preterm infants to mitigate inflammatory risks.