par Gouvêa Bogossian, Elisa 
;Peluso, Lorenzo ;Taccone, Fabio
Référence Transfusion Practice in Clinical Neurosciences, Springer Nature, page (485-492)
Publication Publié, 2022-01
;Peluso, Lorenzo ;Taccone, Fabio Référence Transfusion Practice in Clinical Neurosciences, Springer Nature, page (485-492)
Publication Publié, 2022-01
Partie d'ouvrage collectif
| Résumé : | Red blood cell (RBC) transfusions are a frequent intervention in critically ill patients, including those with traumatic brain injury. Indeed, anemia is frequent in these patients and is associated with an increased risk of poor outcome; transfusions are often given to try and improve oxygen delivery and tissue oxygenation. The pathophysiology of anemia in patients with traumatic brain injury is multifactorial, including primary blood loss because of bleeding and secondary loss related to minor procedures or phlebotomy, hemodilution secondary to fluid resuscitation, and altered RBC production. The aim of RBC transfusion in patients with traumatic brain injury is essentially to increase cerebral oxygenation, but it is not clear whether RBC transfusion has a beneficial effect on oxygenation in patients with moderate anemia. Moreover, complications of transfusion, including transfusion-associated circulatory overload and transfusion-related acute lung injury, may offset its potential benefits. The optimal hemoglobin level that could be used to trigger RBC transfusion in patients with traumatic brain injury is undefined. In this chapter, we summarize recent data on the effects of anemia and RBC transfusion on cerebral oxygenation and on outcomes in patients with traumatic brain injury and suggest how best to optimize transfusion management in these patients. |
