Liberal Versus Restrictive Transfusion Trigger after Acute Brain Injury: More than Just Higher Blood Oxygen Content.

IF 1.8 Q3 CLINICAL NEUROLOGY
Neurotrauma reports Pub Date : 2025-03-19 eCollection Date: 2025-01-01 DOI:10.1089/neur.2025.0008
Adrienne K Ho
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Abstract

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.

急性脑损伤后自由与限制性输血触发:不仅仅是更高的血氧含量。
先前对危重患者或心脏手术患者限制性与自由血红蛋白输血触发因素的研究已经建立了一个支持限制性触发因素的范例。相比之下,创伤性脑损伤优化中的血红蛋白输血阈值和急性脑损伤患者的输血策略试验(2024)表明,在急性脑损伤贫血患者中,自由血红蛋白(90-100 g/L)输血触发比限制性(70 g/L)触发与更好的神经预后相关。增加的血氧含量是一个明显的可能的原因,观察到更好的神经预后与更多的自由红细胞输血。在作者看来,另一个合理的原因是,在替换颅外失血量时,这两个试验中的大多数患者都有,避免可能加重颅内高压的血液替代品也可能使自由输血组受益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
2.40
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0.00%
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