title: Blood transfusion practices in neuroanaesthesia.
abstract: Neuroanaesthesia practice is associated with risk of significant blood loss resulting in anaemia in the intraoperative and postoperative period. The transfusion triggers in a neurologically injured brain are not clearly defined. Both a low haematocrit and a high haematocrit have not shown any improvement in the outcome. Transfusion of red blood cells may improve the cerebral oxygenation on neurophysiological monitors. However, these benefits have not been translated into clinical practice. Transfusion in subarachnoid haemorrhage leads to increased incidence of vasospasm and a poor outcome. Restrictive transfusion strategy is seen to have a lower incidence of pneumonia, urinary tract infection, bacteremia and septic shock in severe head injury. Current evidence suggests that a haemoglobin (Hb) level of <7 g/dl may be deleterious to the neurosurgical population. Target Hb of 8-9 g/dl may be desirable intraoperatively. Different transfusion triggers may hold true for different neurosurgical pathologies.
authors.affiliation: Department of Anaesthesiology, Division of Neuroanaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Zulfiqar
authors.initials: Z
authors.lastname: Ali
authors.affiliation: Department of General Medicine, Government Gousia Hospital, Srinagar, Jammu and Kashmir, India.
authors.forename: Nelofar
authors.initials: N
authors.lastname: Hassan
authors.affiliation: Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Sumaya
authors.initials: S
authors.lastname: Syed
keywords: Blood transfusion; head injury; neuroanaesthesia; stroke; transfusion trigger