• Alberto Castella, Laila Attanasio, Sophie Schuind, Lorenzo Peluso, Filippo Annoni, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone, and Elisa Gouvêa Bogossian.
• Department of Intensive Care, Erasme Hospital-Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.
• Clin Neurol Neurosurg. 2021 Jul 1; 206: 106676.

IntroductionThe benefits of correcting anemia using red blood cell transfusion (RBCT) after subarachnoid hemorrhage (SAH) are controversial. We aimed to evaluate the role of anemia and RBCT on neurological outcome after SAH using a restrictive transfusion policy.ObjectiveWe reviewed our institutional database of adult patients admitted to the Department of Intensive Care (ICU) after non-traumatic SAH over a 5-year period. We recorded hemoglobin (Hb) levels daily for a maximum of 20 days, as well as the use of RBCT. Unfavorable neurological outcome (UO) was defined as a Glasgow Outcome Score of 1-3 at 3 months.ResultsAmong 270 eligible patients, UO was observed in 40% of them. Patients with UO had lower Hb over time and received RBCT more frequently than others (15/109, 14% vs. 6/161, 4% - p < 0.01). Pre-RBCT median Hb values were similar in UO and FO patients (6.9 [6.6-7.1] vs. 7.3 [6.3-8.1] g/dL - p = 0.21). The optimal discriminative Hb threshold for UO was 9 g/dL. In a multivariable analysis, neither anemia nor RBCT were independently associated with UO.ConclusionIn this retrospective single center study using a restrictive strategy of RBCT in SAH patients was not associated with worse outcome in 3 months.Copyright © 2021 Elsevier B.V. All rights reserved.

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