Liberal transfusion strategy may avert unfavorable neurological outcome

Medical Xpress / HealthDay / JAMA / Annual Congress of the Euro Society of Intensive Care Medicine ^ | Oct. 11, 2024 | Elana Gotkine / Fabio Silvio Taccone et al / Alexis F. Turgeon et al

[ConservativeMind]

For patients with acute brain injury, a liberal transfusion strategy is associated with a lower risk for having an unfavorable neurological outcome, according to a study.

Fabio Silvio Taccone, M.D., Ph.D., from the Université Libre de Bruxelles in Brussels, and colleagues examined the impact of two different hemoglobin thresholds to guide red blood cell transfusions on neurological outcome in patients with acute brain injury in a trial conducted in 72 intensive care units across 22 countries. A total of 850 patients were randomly assigned to undergo a liberal or restrictive transfusion strategy over a 28-day period (transfusions triggered by hemoglobin <9 or <7 g/dL, respectively [408 and 442 patients]).

The liberal and restrictive transfusion strategy groups received a median of two and zero units of blood, respectively. The researchers found that 62.6 and 72.6 percent of patients in the liberal and restrictive strategy groups, respectively, had unfavorable neurological outcome at 180 days after randomization (adjusted relative risk, 0.86). Across prespecified subgroups, the effect of transfusion thresholds on neurological outcome at 180 days was consistent. Overall, 8.8 and 13.5 percent of patients in the liberal and restrictive strategy groups, respectively, had at least one cerebral ischemic event (relative risk, 0.65).

"Our findings substantially expand the existing evidence in relation to transfusion thresholds for patients in the intensive care unit with an acute brain injury," the authors write.

[ConservativeMind]

As the transfusions appear to take place over 28 days, it seems prudent to give this study writeup to the doctor of your loved one in the hospital.

You want a liberal transfusion approach using <9 g/dL hemoglobin level cutoff for the transfusion.

[ConservativeMind]

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[AZJeep]

Looks like liberals are good for something?!

[Rockingham]

Among other beneficial effects, transfusions increase magnesium levels in the blood. Notably, magnesium, which is often deficient, helps to relax blood vessels and repair injuries at the cellular level.

For neurological injuries, the blood-brain barrier limits the uptake of drugs and of magnesium and other nutrients. Larger and longer transfusions would thus tend to make increased magnesium available to the brain for longer, with beneficial effects for those suffering neurological injuries. Supplementation of magnesium in the most absorbable amino acid chelated forms might provide equivalent or greater benefits.

[Savage Beast]

"Liberal transfusion strategy may avert unfavorable neurological outcome"

Well by all means let's start transfusing them--and fast!