[Liberal blood transfusion in acute brain injury?]

Whether a liberal or restrictive blood transfusion strategy is the best treatment option in patients with an acute, severe neurological disease, such as traumatic brain injury, an intracranial hemorrhage or a subarachnoid hemorrhage, is unknown. In this article we discuss the TRAIN trial and the current literature regarding a liberal versus a restrictive blood transfusion strategy in this patient category. The TRAIN trial showed a positive effect of a liberal strategy compared to a restrictive blood transfusion strategy in patients with an acute neurological disease. Another study as well as a meta-analysis were also unable to show a positive effect of a liberal blood transfusion strategy in patients with traumatic brain injury. We therefore conclude that at this moment it is too early to adopt a new, liberal blood transfusion strategy in patients with acute, severe neurological disease.