Impact of age of transfused blood on cerebral oxygenation... : Critical Care Medicine (original) (raw)

Neurologic Critical Care

Impact of age of transfused blood on cerebral oxygenation in male patients with severe traumatic brain injury*

Leal-Noval, Santiago Ramón MD, PhD; Muñoz-Gómez, Manuel Prof MD, PhD; Arellano-Orden, Victoria MD; Marín-Caballos, Antonio MD, PhD; Amaya-Villar, Rosario MD, PhD; Marín, Ana MD; Puppo-Moreno, Antonio MD, PhD; Ferrándiz-Millón, Carmen MD; Flores-Cordero, Juan Manuel MD, PhD; Murillo-Cabezas, Francisco MD, PhD

From Neurotrauma Critical Care, Hospital Universitario “Virgen del Rocío,” Seville, Spain (SRLN, VAO, AMC, RAV, MA, APM, CFM, JMFC, FMC); and Transfusion Medicine, School of Medicine, University of Malaga, Malaga, Spain (MMG).

Supported, in part, by Spanish Government funds (FIS PI-040296 and Convenio especifico de colaboración entre el Instituto de Salud Carlos III y la comunidad autónoma andaluza, fundación “Progreso y Salud.” BOE 31, resolución 1907, año 2006).

Consejería de Salud de la Junta de Andalucía. Proyecto de Investigación 0157/2006.

The authors have not disclosed any potential conflicts of interest.

Address requests for reprints to: Santiago R. Leal- Noval, MD, PhD, Servicio de Cuidados Críticos y Urgencias, Hospital Universitario “Virgen del Rocío,” Avda/ Manuel Siurot, s/n°, 41013, Seville, Spain. E-mail: [email protected]

Abstract

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.

Design:

Prospective, observational study.

Setting:

Neurotrauma critical care unit of a university hospital.

Patients:

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

Interventions:

None.

Measurements and Main 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.