Transfusion requirements after head trauma: a randomized feasibility controlled trial

Anemia is frequent among patients with traumatic brain injury (TBI) and is associated with an increased risk of poor outcome. The optimal hemoglobin concentration to trigger red blood cell (RBC) transfusion in patients with TBI is not clearly defined. All eligible consecutive adult patients admitted...

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Bibliographic Details
Published in:Critical care (London, England) England), 2019-03, Vol.23 (1), p.89-89, Article 89
Main Authors: Gobatto, André L N, Link, Milena A, Solla, Davi J, Bassi, Estevão, Tierno, Paulo F, Paiva, Wellingson, Taccone, Fabio S, Malbouisson, Luiz M
Format: Article
Language:English
Subjects:
Adult
Anemia
Anemia - complications
Anemia - therapy
Blood transfusion
Blood Transfusion - methods
Blood Transfusion - standards
Brain injuries
Brazil
Complications and side effects
Craniocerebral Trauma - physiopathology
Craniocerebral Trauma - therapy
Feasibility Studies
Female
Glasgow Coma Scale
Glycosylated hemoglobin
Head injuries
Hemoglobins
Hospital patients
Humans
Intensive Care Units - organization & administration
Intensive Care Units - statistics & numerical data
Intracranial pressure
Male
Middle Aged
Mortality
Patient outcomes
Risk factors
Transfusion
Traumatic brain injury
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Summary:Anemia is frequent among patients with traumatic brain injury (TBI) and is associated with an increased risk of poor outcome. The optimal hemoglobin concentration to trigger red blood cell (RBC) transfusion in patients with TBI is not clearly defined. All eligible consecutive adult patients admitted to the intensive care unit (ICU) with moderate or severe TBI were randomized to a "restrictive" (hemoglobin transfusion threshold of 7 g/dL), or a "liberal" (threshold 9 g/dL) transfusion strategy. The transfusion strategy was continued for up to 14 days or until ICU discharge. The primary outcome was the mean difference in hemoglobin between groups. Secondary outcomes included transfusion requirements, intracranial pressure management, cerebral hemodynamics, length of stay, mortality and 6-month neurological outcome. A total of 44 patients were randomized, 21 patients to the liberal group and 23 to the restrictive group. There were no baseline differences between the groups. The mean hemoglobin concentrations during the 14-day period were 8.4 ± 1.0 and 9.3 ± 1.3 (p 
ISSN:1364-8535
1466-609X
1364-8535
DOI:10.1186/s13054-018-2273-9