Donors on development of ALI, gas exchange, and outcome in critically ill patients. Methods In this retrospective case KKL-35 web ontrol study we identified patients who received more than two units of high plasma volume components from male-only donors and compared them with patients matched by severity of illness, postoperative state and number of transfusions but who received high plasma volume components from female donors. Results From a database of 3,567 patients who received a total of 46,101 units fresh frozen plasma and 6,251 units apheresis platelets, we identified 112 patients who received three or PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20737790 more male-only donor components and 112 matched controls. Baseline characteristics, ALI risk factors and development of ALI were similar between the two groups. Arterial oxygenation (PaO2/FiO2) worsened after the female donor components (mean difference ?2, 95 CI ?4 to ?1, P = 0.008) but not after male-only donor product transfusion (mean difference +22, 95 CI ?3 to + 67, P = 0.325). Male-only component recipients had more ventilatorfree days (median 28 vs 27, P = 0.006) and a trend towards lower hospital mortality (14 vs 24 , P = 0.054). Conclusion In critically ill recipients of high plasma volume components, gas exchange worsened significantly after transfusion of female but not male donor components. Prospective studies are needed to evaluate the effect of AABB recommendations on outcome of transfused critically ill patients.P411 Evaluation of red blood cell transfusion effects in lactate and central venous oxygen saturation in patients with severe sepsis and septic shockB Mazza, M Assuncao, F Freitas, M Jackiu, H Fernandes, F Machado Escola Paulista de Medicina ?Universidade Federal de S Paulo, Brazil Critical Care 2007, 11(Suppl 2):P411 (doi: 10.1186/cc5571) Introduction Red blood cell (RBC) transfusion is very often performed in critically ill patients despite its potential complications. Its effects on oxygen delivery and microcirculation are not well known. This study aimed at evaluating RBC effects in blood lactate levels (LAC) and central venous oxygen saturation (SvcO2) in patients with severe sepsis and septic shock. Methods A prospective study enrolling patients admitted to an ICU at a university hospital with severe sepsis and septic shock presenting hemoglobin (Hb) levels below 9.0 g/dl. These patients were randomized for maintaining Hb >9 g/dl (Group 1) or >7 g/dl (Group 2). Before (preT) and at least 1 hour after each transfusion (postT) LAC, SvcO2 and Hb data were collected. Data were analysed by analysis of variance, paired t test and paired Wilcoxon test. Results were considered significant if P 0.05. Results Thirty-six transfusions were evaluated in 21 patients (mean age 59.0 ?15.8 years, 11 females/10 males) with APACHE II score of 13.8 ?4.1. Each group included 18 patients. The levels of Hb preT and postT were 7.51 ?1.03 and 8.48 ?1.15 (P < 0.05). There was a significant difference between preT and postT SvcO2 (70.9 ?8.66 and 73.6 ?7.2, P = 0.01) but not in LAC levels (24.1 ?8.9 and 22.9 ?7.6, P = 0.45). When groups were analyzed separately, only in Group 2 was a significant difference found (P = 0.0005 and 0.05, respectively for SvcO2 and LAC). In 10 transfusions a worsening of SvcO2 postT wasConclusion These results give further validation to Stewart's theories: the SID appears to maintain the role of an independent variable with respect to bicarbonate even at low haemoglobin levels, while chloride loses this r.