Physiopathology of anemia and transfusion thresholds in isolated head injury

Bellapart, Judith, Boots, Rob and Fraser, John (2012) Physiopathology of anemia and transfusion thresholds in isolated head injury. Journal of Trauma and Acute Care Surgery, 73 4: 997-1005. doi:10.1097/TA.0b013e318265cede

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Author Bellapart, Judith
Boots, Rob
Fraser, John
Total Author Count Override 3
Title Physiopathology of anemia and transfusion thresholds in isolated head injury
Journal name Journal of Trauma and Acute Care Surgery   Check publisher's open access policy
ISSN 2163-0755
2163-0763
Publication date 2012-10
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/TA.0b013e318265cede
Volume 73
Issue 4
Start page 997
End page 1005
Total pages 9
Place of publication Chicago, IL, United States
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Formatted abstract
BACKGROUND: Blood transfusion strategies among patients with critical illness use a restrictive hemoglobin threshold. However, among patients with head injury, no outcome differences have been shown between either liberal or restrictive strategies. Several studies and literature reviews suggest that anemia is associated with markers of tissue ischemia. The paucity of prospective data confuses the association between surrogates of tissue ischemia and neurological outcome.
METHODS: A narrative review of transfusion practices among patients in the acute phase of head injury was performed using PubMed, MEDLINE, EMBASE, Cochrane, and WEB of Science databases. A total of 104 articles were reviewed.
RESULTS: There are few data to guide clinical practice. Clinicians use blood hemoglobin concentrations to trigger transfusion. Markers of potential cerebral injury are not in regular use despite experimental and observational data rising from histologic examination, microdialysis, oximetry, and flow-based multimonitoring systems recommending their use to titrate blood transfusion in neurotrauma.
CONCLUSION: The generalization of transfusion triggers is common practice. Evidence-based approaches to transfusions strategies in head injury are lacking and not based on an understanding of cerebral physiopathology.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 05 Nov 2012, 14:35:59 EST by Matthew Lamb on behalf of School of Medicine