Standard Issue Transfusion Versus Fresher Red Blood Cell Use in Intensive Care- A Randomised Controlled Trial

Inclusion criteria •Patients hospitalised in ICU with an anticipated ICU stay of at least 24 hours, in whom the decision has been made by medical staff to transfuse at least one RBC unit. Exclusion criteria * Age younger than 18 * Previous RBC transfusion during the current hospital admission (including transfusion in another hospital for transferred patients) * Diagnosis of transplantation or hematologic diseases * Pregnancy * Cardiac surgery during the present hospital admission * Expected to die imminently (\<24hrs) * The treating physician believes it is not in the best interest of the patient to be randomised in this trial. * Known objection to the administration of human blood products * Participation in a competing study Primary outcome- 90 day mortality Secondary outcomes 1. 28 day mortality 2. Persistent Organ Dysfunction combined with death at 28 3. Days alive and free of mechanical ventilation at day 90 post randomisation 4. Day alive and free of renal replacement therapy at day 90 post randomisation 5. Blood stream infection in ICU (post randomisation) defined using the Center for Disease Control and Prevention/National Healthcare Safety Network criteria 6. Length of stay in ICU and in hospital post randomisation 7. Febrile non-haemolytic transfusion reactions 8. EQ-5D score at Day 90 post randomisation