Gender influences cerebral oxygenation after red blood cell transfusion in patients with severe traumatic brain injury.
BACKGROUND
Important differences with respect to gender exist in the prognosis and mortality of traumatic brain injury (TBI) patients. The objective of this study was to assess the role of gender as an independent factor in cerebral oxygenation variations following red blood cell transfusion (RBCT).


METHODS
This retrospective analysis of a prospective study was conducted on patients with severe TBI. Hemoglobin levels were measured at baseline and 6 h after transfusion. Brain tissue oxygen pressure (PbrO(2)), cerebral perfusion pressure (CPP), intracranial pressure (ICP), and mean arterial pressure (MAP) were measured at baseline, at the end of RBCT and at 1, 2, 3, 4, 5, and 6 h after transfusion. After the patients were stratified into two groups according to gender, the effect of RBCT on PbrO(2) (cerebral oxygenation) was analyzed using a multivariate analysis of variance with repeated measures (MANOVA). The MANOVA was repeated after adjusting for all covariables with baseline differences between groups.


RESULTS
At baseline, we found differences in age (P = 0.01), weight (P = 0.03), MAP (P = 0.01), ISS (P = 0.05), and CCP (P = 0.01) between the groups. After adjusting for these co-variables, we observed that gender and age were related to the increase in PbrO(2) (P = 0.05 and P = 0.04, respectively).


CONCLUSIONS
Our results suggest that the effect of RBCT on cerebral oxygenation, as measured by PbrO(2), is greater in women than in men.
Arellano-Orden
Victoria
V
Neuro Critical Care Division, Hospital Virgen del Rocío, Sevilla, Spain.
Leal-Noval
Santiago R
SR
Cayuela
Aurelio
A
Muñoz-Gómez
Manuel
M
Ferrándiz-Millón
Carmen
C
García-Alfaro
Claudio
C
Marín-Caballos
Antonio
A
Domínguez-Roldán
José Ma
JM
Murillo-Cabezas
Francisco
F
D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000378:metabolism; D001930:Brain Injuries / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy*; D003422:Critical Care / Q000379:methods; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011379:Prognosis; D012189:Retrospective Studies; D012727:Sex Characteristics; D016896:Treatment Outcome; D055815:Young Adult
D010100:Oxygen