Abstract
Most healthy humans have a haemoglobin concentration of 12 to 15 g/dL and most intensivists now transfuse packed red blood cells for haemoglobin <7 g/dL. Higher haemoglobin is associated with improved intermediate and clinical outcomes after subarachnoid hemorrhage (from ruptured brain aneurysm) or neurotrauma. An observational study in a recent issue shows that higher haemoglobin was associated with better functional outcomes in patients with spontaneous intracerebral haemorrhage; few patients received a packed red blood cell transfusion, so it is not known if that treatment is better than the disease. The mechanism of anaemia's purported impact on outcome is unclear, although altered metabolism in brain tissue that is sensitive to reduced oxygen delivery is plausible. These data may intensify the differences of opinion between intensivists: whether neurologic patients are better served by higher haemoglobin and potentially by more packed red blood cell transfusion, or simply need to be studied more in prospective clinical trials, remains unclear.
| Original language | English (US) |
|---|---|
| Article number | 149 |
| Journal | Critical Care |
| Volume | 14 |
| Issue number | 3 |
| DOIs |
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| State | Published - May 12 2010 |
Funding
AMN has received grant support for a prospective, randomized trial of goal haemoglobin in patients with subarachnoid hemorrhage from NovoNordisk and the Neurocritical Care Society and the Northwestern Memorial Foundation. That study is over and the results are under peer review. AMN has previously published on the topic of anaemia and subarachnoid hemorrhage, as cited in the article under discussion; this may be perceived as a nonfinancial competing interest.
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine