Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content
Previous studies on restrictive versus liberal blood hemoglobin transfusion triggers in critically ill or cardiac surgery patients had established a paradigm favoring restrictive triggers. In contrast, the hemoglobin transfusion threshold in traumatic brain injury optimization and transfusion strate...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2025-01-01
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| Series: | Neurotrauma Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/neur.2025.0008 |
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| author | Adrienne K. Ho |
| author_facet | Adrienne K. Ho |
| author_sort | Adrienne K. Ho |
| collection | DOAJ |
| description | Previous studies on restrictive versus liberal blood hemoglobin transfusion triggers in critically ill or cardiac surgery patients had established a paradigm favoring restrictive triggers. In contrast, the hemoglobin transfusion threshold in traumatic brain injury optimization and transfusion strategy in patients with acute brain injury trials (2024) suggest that a liberal hemoglobin (90–100 g/L) transfusion trigger is associated with better neuro-outcomes than a restrictive (70 g/L) trigger in anemic patients with acute brain injury. Increased blood oxygen content is one obvious possible reason for the observed superior neuro-outcomes with more liberal red blood cell transfusion. In this author’s opinion, another plausible reason is that in replacing extracranial blood loss, which most of the patients in both trials had, avoidance of blood alternatives that could worsen intracranial hypertension might also have benefitted the liberal transfusion cohorts. |
| format | Article |
| id | doaj-art-86279b2cf01a48b5b9c96065a9ef2604 |
| institution | OA Journals |
| issn | 2689-288X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Neurotrauma Reports |
| spelling | doaj-art-86279b2cf01a48b5b9c96065a9ef26042025-08-20T02:30:55ZengMary Ann LiebertNeurotrauma Reports2689-288X2025-01-016125726010.1089/neur.2025.0008Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen ContentAdrienne K. Ho0Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada.Previous studies on restrictive versus liberal blood hemoglobin transfusion triggers in critically ill or cardiac surgery patients had established a paradigm favoring restrictive triggers. In contrast, the hemoglobin transfusion threshold in traumatic brain injury optimization and transfusion strategy in patients with acute brain injury trials (2024) suggest that a liberal hemoglobin (90–100 g/L) transfusion trigger is associated with better neuro-outcomes than a restrictive (70 g/L) trigger in anemic patients with acute brain injury. Increased blood oxygen content is one obvious possible reason for the observed superior neuro-outcomes with more liberal red blood cell transfusion. In this author’s opinion, another plausible reason is that in replacing extracranial blood loss, which most of the patients in both trials had, avoidance of blood alternatives that could worsen intracranial hypertension might also have benefitted the liberal transfusion cohorts.https://www.liebertpub.com/doi/10.1089/neur.2025.0008brain injurytransfusion |
| spellingShingle | Adrienne K. Ho Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content Neurotrauma Reports brain injury transfusion |
| title | Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content |
| title_full | Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content |
| title_fullStr | Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content |
| title_full_unstemmed | Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content |
| title_short | Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content |
| title_sort | liberal versus restrictive transfusion trigger after acute brain injury more than just higher blood oxygen content |
| topic | brain injury transfusion |
| url | https://www.liebertpub.com/doi/10.1089/neur.2025.0008 |
| work_keys_str_mv | AT adriennekho liberalversusrestrictivetransfusiontriggerafteracutebraininjurymorethanjusthigherbloodoxygencontent |