Abstract Details

Title Liberal Versus Restrictive Transfusion Strategy in Traumatic Brain Injury: An Updated Meta-analysis

Topic Neuro Trauma and Critical Care

Presentation(s) P10 - Poster Session 10 (5:00 PM-6:00 PM)

Poster/Presentation
Number 7-009

Objective

To find the optimal transfusion strategy for patients with traumatic brain injury (TBI) and concomitant anemia.

Background

Anemia is common in TBI and increases the risk of worsening cerebral ischemia. The optimal transfusion strategy for patients with TBI is still unclear.

Design/Methods

We systematically searched the PubMed, Scopus, and Cochrane Central databases for studies comparing transfusion initiated at hemoglobin levels of ≤ 10 g/dL (liberal) and ≤ 7 g/dL (restrictive). Statistical analysis was performed using R software and followed PRISMA guidelines.

Results

We included 1,047 patients from 4 RCTs, where 50.52% of patients received a liberal transfusion. Unfavorable GOS (RR 0.98; 95%CI 0.80-1.20; p=0.82), ICU mortality (RR 0.75; 95%CI 0.30-1.88; p=0.53), in-hospital mortality (RR 0.82; 95%CI 0.42-1.61; p=0.56), mortality at 6 months (RR 1.01; 95%CI 0.81-1.26; p=0.92), stroke (RR 1.84; 95%CI 0.65-5.22; p=0.25), MI (RR 0.51; 95%CI 0.09-2.94; p=0.45), ARDS (RR 1.89; 95%CI 0.95-3.75; p=0.06), pneumonia (RR 1.08; 95%CI 0.89-1.30; p=0.45), DVT (RR 1.60; 95%CI 0.78-3.29; p=0.20), pulmonary embolism (RR 1.54; 95%CI0.66-3.59; p=0.31), CNS infection (RR 0.84; 95%CI 0.44-1.62; p=0.60), bacteremia (RR 0.88; 95%CI 0.54-1.43; p=0.59), sepsis/septic shock (RR 0.73; 95%CI 0.47-1.13; p=0.15), seizure (RR 1.21; 95%CI 0.74-1.98; p=0.45), hospital LOS (MD -2.30; 95%CI -15.07-10.47; p=0.72), ICU stay (MD -0.41; 95%CI -7.62-6.80; p=0.91), and surgical site infection (RR 0.72; 95%CI 0.29-1.78; p=0.48) were comparable between both strategies.

Conclusions

Liberal and restrictive transfusion was comparable in critically ill patients with TBI.

Authors/Disclosures
Eshita Sharma PRESENTER	Miss Sharma has nothing to disclose.
Mrinal M. Murali Krishna, MBBS	Dr. Murali Krishna has nothing to disclose.
Meghna Joseph, MBBS	Dr. Joseph has nothing to disclose.
Vinicius Pereira, MD	Mr. Pereira has nothing to disclose.
Chidubem Ezenna, MD	Dr. Ezenna has nothing to disclose.
Julyana M. Dantas, MD	Dr. Dantas has nothing to disclose.
Mithun M. Krishna, MD, MBBS	Dr. Krishna has nothing to disclose.
Isaac Yang, MD	Dr. Yang has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Baxter. The institution of Dr. Yang has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Brainlab. Dr. Yang has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Yang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Yang has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Isaac Yang MD. Dr. Yang has received research support from Acoustic Neuroma Association. Dr. Yang has received publishing royalties from a publication relating to health care.

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