Abstract
To the Editor. —The study by Drs Marik and Sibbald1was interesting and thought-provoking. The authors make a very important clinical point relating to the role of red blood cell transfusions in the therapy of the septic patient. In this regard, I would like to highlight some additional data relevant to the subject. The authors comment on reduced 2,3 diphosphoglycerate, adenosine triphosphate, and red blood cell deformability as the factors responsible for the lowered oxygen consumption following stored red blood cell transfusion. Studies of banked blood have revealed other possibly significant changes in red blood cells over time. Uchida and coworkers2showed that methemoglobin levels increased during storage (from 1.3% to 2.4% in 3 weeks), while carboxyhemoglobin levels remained high (range, 0% to 9.6%) with a half-life of 47 days. It is suggested that the use of banked blood containing high levels of these abnormal hemoglobins may pose
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