Impact of age of transfused blood on cerebral oxygenation in male patients with severe traumatic brain injury.
OBJECTIVE
Prolonged erythrocyte storage time might reduce the efficacy of transfusion. In this study, the effects of transfusion of erythrocytes with four different storage periods (<10 days, n = 18; 10-14 days, n = 15; 15-19 days, n = 17; and >19 days, n = 16 patients) on brain tissue oxygen tension (PtiO2) in stable male patients with severe traumatic brain injury were investigated during a 24-hr follow-up period.


METHODS
Prospective, observational study.


METHODS
Neurotrauma critical care unit of a university hospital.


METHODS
Sixty-six male, nonbleeding, hemodynamically stable anemic patients (hemoglobin <95 g/L) with Glasgow Coma Scale score <9.


METHODS
None.


RESULTS
PtiO2, cerebral perfusion pressure, mean arterial pressure, intracranial pressure, peripheral oxygen saturation, CO2 pressure at the end of expiration, and intracerebral temperature were recorded in all patients at baseline, immediately after the completion of transfusion, and 1, 2, 3, 4, 5, 6, 12, and 24 hrs posttransfusion. All four groups were homogeneous with respect to multiple baseline variables, except for storage time of transfused erythrocytes (p < .0001). There was a significant short-lasting (3-4 hrs) increase in PtiO2 values after transfusion of erythrocytes stored for <10 days, 10-14 days, or 15-19 days, compared with those at baseline. In contrast, no significant changes in PtiO2 were observed after transfusion of erythrocytes stored >19 days.


CONCLUSIONS
Transfusion of erythrocytes increased cerebral oxygenation in patients with severe traumatic brain injury, except in those transfused with erythrocytes stored >19 days.
Leal-Noval
Santiago Ramón
SR
Neurotrauma Critical Care, Hospital Universitario Virgen del Rocío, Seville, Spain. sramon@cica.es
Muñoz-Gómez
Manuel
M
Arellano-Orden
Victoria
V
Marín-Caballos
Antonio
A
Amaya-Villar
Rosario
R
Marín
Ana
A
Puppo-Moreno
Antonio
A
Ferrándiz-Millón
Carmen
C
Flores-Cordero
Juan Manuel
JM
Murillo-Cabezas
Francisco
F
D000328:Adult; D001793:Blood Preservation; D001921:Brain / Q000098:blood supply*; D001930:Brain Injuries / Q000503:physiopathology / Q000628:therapy*; D017707:Erythrocyte Transfusion; D006801:Humans; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D011446:Prospective Studies; D013997:Time Factors; D014193:Trauma Centers
D010100:Oxygen