“ In light of the overall results of our study and considering the safety of current blood transfusions , the liberal strategy is probably the option that should be preferred in the acute phase of care to improve long-term prognosis following TBI .”
Issue 33.3 SUMMER 2024
carry oxygen to the tissues and organs . Most patients hospitalized after a TBI suffer from anemia , defined as low hemoglobin concentration , which could reduce oxygen transport to the brain during a period when it is most vulnerable ,” points out François Lauzier , also a professor at Université Laval and who co-led the study with Professor Dean Fergusson of the Ottawa Hospital Research Institute .
The restrictive approach consists in tolerating a low hemoglobin level before giving a transfusion , while a liberal approach aims to maintain high hemoglobin levels , thus giving more blood transfusion .
“ By improving oxygen transport to the brain during the acute phase of care , it may be possible to save more nerve cells in the days following a TBI , thereby preventing additional brain damage ,” says Professor Turgeon .
To conduct the study , the research team recruited 742 critically ill patients with moderate or severe TBI and anemia defined as a hemoglobin level of 10 g / decilitre or less during hospitalization . Randomly divided into two groups , these individuals were subjected to one or other of the transfusion strategies during their stay in the intensive
care unit . To maintain these thresholds , the care teams administered blood transfusions whenever necessary .
Six months after TBI , the research team assessed the level of overall recovery for each group , including neurovegetative status , dependence on activities of daily living and impairments preventing resumption of activities that had been performed prior to TBI . “ The combined incidence of death and major disability was not statistically different between the two groups , but seemed favouring the liberal strategy in all analyses ,” says Professor Turgeon . What ’ s more , those treated using the liberal approach showed a higher functional independence measure and quality of life index than those treated using the restrictive approach .
“ In light of the overall results of our study and considering the safety of current blood transfusions , the liberal strategy is probably the option that should be preferred in the acute phase of care to improve long-term prognosis following TBI ,” concludes Professor Turgeon . g
“ In light of the overall results of our study and considering the safety of current blood transfusions , the liberal strategy is probably the option that should be preferred in the acute phase of care to improve long-term prognosis following TBI .”
18