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Outcomes in traumatic brain injury are improved when physiologic homeostasis is achieved as soon as possible after injury. Here are the American College of Surgeons’ recommendations. Note SBP over 110 and a hemoglobin over 7. A study looking at a more liberal transfusion target showed worse ARDS and no mortality benefit.
References
- American College of Surgeons Committee on Trauma. Best Practices Guidelines on the Management of Traumatic Brain Injury. American College of Surgeons; 2024. https://www.facs.org/media/vgfgjpfk/best-practices-guidelines-traumatic-brain-injury.pdf
2. Liberal or Restrictive Transfusion Strategy in Patients with Traumatic Brain Injury
Authors: Alexis F. Turgeon, M.D. https://orcid.org/0000-0001-5675-8791, Dean A.Fergusson, Ph.D., Lucy Clayton, M.Sc., Marie-Pier Patton, M.Sc., Xavier Neveu, M.Sc., Timothy S. Walsh, M.D., Annemarie Docherty, M.D., Ph.D., +48 , for the HEMOTION Trial Investigators on behalf of the Canadian Critical Care Trials Group, the Canadian Perioperative Anesthesia Clinical Trials Group, and the Canadian Traumatic Brain Injury Research Consortium*
June 13, 2024N Engl J Med 2024;391:722-735DOI: 10.1056/NEJMoa2404360VOL. 391 NO. 8