ABC-PICU is a multi-center, international, pragmatic, double-blind, randomized clinical trial comparing the risk of New or Progressive Multiple Organ Dysfunction Syndrome (NPMODS) between critically ill children transfused red blood cells (RBCs) of decreased storage age and those transfused standard issue RBCs. The objective of this study is to answer the specific question, "Does the transfusion of RBCs of decreased storage duration improve outcomes in critically ill patients?"

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