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Related Concept Videos

Blood Transfusion and Agglutination02:45

Blood Transfusion and Agglutination

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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
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The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
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Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
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A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
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Liberal or Restrictive Transfusion Strategy in Patients with Traumatic Brain Injury.

Alexis F Turgeon1, Dean A Fergusson1, Lucy Clayton1

  • 1From the Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine (A.F.T., M.V., M.S.-O., F. Lauzier), the Department of Social and Preventive Medicine (L.M.), the Department of Surgery, Division of Neurosurgery (P.L.B.), the Department of Medicine (V.L., F. Lauzier), and the Department of Family and Emergency Medicine (M.S.-O.), Faculty of Medicine, Université Laval, the Population Health and Optimal Health Practice Unit, Centre Hospitalier Universitaire de Québec-Université Laval Research Center (A.F.T., L.C., M.-P.P., X.N., L.M., P.L.B., M.V., M.S.-O., O.C., F. Lauzier), and the Department of Anesthesia, Critical Care Medicine Service, Hôpital de L'Enfant-Jésus, Centre Hospitalier Universitaire de Québec-Université Laval (A.F.T., F. Lauzier), Quebec City, QC, Ottawa Hospital Research Institute (D.A.F., S.W.E., T.R., M.T., A.T.), the School of Epidemiology and Public Health (D.A.F., S.W.E., T.R., M.T., A.T.), the Division of Critical Care (S.W.E.), the Division of Hematology (A.T.), and the Division of Palliative Care (P.C.H.), the Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal (L.C.), the Department of Internal Medicine (R.Z.), the Departments of Surgery and of Human Anatomy and Cell Science (F.Z., A.G.), Rady Faculty of Health Sciences, and the Biomedical Engineering Program, Faculty of Engineering (F.Z.), University of Manitoba, and the Department of Medical Oncology-Hematology and the Paul Albrechtsen Research Institute, CancerCare Manitoba (R.Z.), Winnipeg, the Department of Critical Care Medicine, Sunnybrook Health Sciences Center and Sunnybrook Research Institute (D.C.S., N.K.J.A.), and the Interdepartmental Division of Critical Care Medicine, University of Toronto (D.C.S., N.K.J.A., A.R., K.E.A.B., J.M.), Toronto, the Departments of Critical Care Medicine and Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (A.K.), the Departments of Medicine and of Epidemiology and Biostatistics, Western University, London, ON (I.B.), the Departments of Surgery and Critical Care Medicine, McGill University Health Centre, Montreal (K.K.), the Department of Medicine, Faculty of Medicine, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC (F. Lamontagne), the Department of Surgery, Division of Neurosurgery, McMaster University, Hamilton Health Sciences, Hamilton, ON (A.A.), the Department of Anesthesia, St. Michael's Hospital, University of Toronto (A.R.), the Applied Health Research Centre, Li Ka Shing Knowledge Institute, and the Department of Critical Care, Unity Health Toronto-St. Michael's Hospital (K.E.A.B., J.M.), Toronto, the Departments of Medicine (A.F.-R.) and Health Research Methods, Evidence and Impact (K.E.A.B.), McMaster University, Hamilton, ON, the Department of Medicine, Division of Critical Care Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver (D.E.G.), the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (D.J.K.), Trauma Nova Scotia, Nova Scotia Health, and the Departments of Critical Care, Emergency Medicine, and Anesthesia and Surgery, Dalhousie University, Halifax (R.G.), the Department of Medicine, Division of Neurology, and the Department of Critical Care Medicine, School of Medicine, Queen's University, Kingston, ON (J.G.B.), the Department of Medicine, Centre Hospitalier de l'Université de Montréal, and the Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal (E.C., M.C.), Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Mauricie-et-du-Centre-du-Québec, Trois-Rivières (E.C.), the University of Saskatchewan, College of Medicine, and Saskatchewan Health Authority-Regina Area, Regina (E.S.), and Bruyère Research Institute, University of Ottawa, Ottawa (P.C.H.) - all in Canada; Usher Institute of Population Health Sciences (T.S.W., A.D.) and the Department of Anaesthesia, Critical Care, and Pain Medicine (T.S.W., A.D., J.R.), Edinburgh Medical School, University of Edinburgh, Edinburgh, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford (J.G.), the Department of Critical Care Medicine, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London (V.G.R.), Cardiff University and the University of Wales Hospital, Cardiff (M.W.), Nottingham University Hospitals NHS Trust, Nottingham (D.H.), University Hospitals North Midlands-Royal Stoke Hospital, Stoke-on-Trent (S.K.), the Division of Anaesthesia, Addenbrooke's Hospital, University of Cambridge, Cambridge (F.Z.), James Cook University Hospital, Middlesbrough (J.W.), and the Walton NHS Foundation Trust (P.N.) and the Department of Intensive Care Medicine, Liverpool University Hospitals NHS (T.A.), Liverpool - all in the United Kingdom; Surgical Intensive Care Unit, Anesthesiology Division, Hospital das Clínicas, University of São Paulo Medical School (L.M.M.), and the Intensive Care Unit, Hospital de Amor de Nossa Senhora (L.S.S.) - both in São Paulo; the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Besançon, Besançon (S.P.-F.), Département Anesthésie Réanimation et Médecine Périopératoire, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Clermont-Ferrand (R.C.), Hôpital de Hautepierre, Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpitaux Universitaires de Strasbourg, Strasbourg (J.P.), and UR-UM103 IMAGINE, University of Montpellier, Division of Anesthesia and Critical Care, Pain, and Emergency Medicine, Nîmes University Hospital, Montpellier (C.R.) - all in France.

The New England Journal of Medicine
|June 13, 2024
PubMed
Summary
This summary is machine-generated.

A liberal red blood cell transfusion strategy did not improve neurologic outcomes for critically ill patients with traumatic brain injury and anemia compared to a restrictive strategy. This study found no significant difference in unfavorable outcomes at six months between the two transfusion approaches.

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Area of Science:

  • Critical Care Medicine
  • Neurology
  • Transfusion Medicine

Background:

  • The optimal red blood cell transfusion strategy for critically ill patients with traumatic brain injury (TBI) and anemia remains uncertain.
  • Existing evidence is insufficient to guide transfusion decisions in this specific patient population.

Purpose of the Study:

  • To compare the effectiveness of a liberal versus a restrictive red blood cell transfusion strategy on neurologic outcomes in critically ill patients with TBI and anemia.
  • To evaluate the impact of transfusion strategies on mortality, functional independence, quality of life, and depression at six months post-injury.

Main Methods:

  • Randomized controlled trial involving 742 adults with moderate to severe TBI and anemia.
  • Patients were assigned to either a liberal transfusion strategy (hemoglobin threshold ≤10 g/dL) or a restrictive strategy (hemoglobin threshold ≤7 g/dL).
  • The primary outcome was an unfavorable outcome at 6 months, assessed using the Glasgow Outcome Scale-Extended (GOSE).

Main Results:

  • A liberal transfusion strategy did not significantly reduce the rate of unfavorable neurologic outcomes compared to a restrictive strategy (68.4% vs. 73.5%).
  • No significant differences were observed in mortality or depression between the groups.
  • The liberal strategy was associated with higher scores on some functional independence and quality of life scales among survivors.

Conclusions:

  • In critically ill patients with TBI and anemia, a liberal red blood cell transfusion strategy does not appear to improve neurologic outcomes at six months.
  • The findings suggest that current transfusion thresholds may not significantly alter the trajectory of neurologic recovery in this patient group.
  • Further research may be needed to identify specific subgroups who might benefit from different transfusion approaches.