• Critical care medicine · Jun 2022

    Factors Associated With Brain Tissue Oxygenation Changes After RBC Transfusion in Acute Brain Injury Patients.

    • Elisa Gouvêa Bogossian, Verena Rass, Anna Lindner, Carolina Iaquaniello, John Paul Miroz, Elaine Cavalcante Dos Santos, Hassane Njimi, Jacques Creteur, Mauro Oddo, Raimund Helbok, and Fabio Silvio Taccone.
    • Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
    • Crit. Care Med. 2022 Jun 1; 50 (6): e539e547e539-e547.

    ObjectivesAnemia is common after acute brain injury and can be associated with brain tissue hypoxia. RBC transfusion (RBCT) can improve brain oxygenation; however, predictors of such improvement remain unknown. We aimed to identify the factors associated with PbtO2 increase (greater than 20% from baseline value) after RBCT, using a generalized mixed model.DesignThis is a multicentric retrospective cohort study (2012-2020).SettingThis study was conducted in three European ICUs of University Hospitals located in Belgium, Switzerland, and Austria.PatientsAll patients with acute brain injury who were monitored with brain tissue oxygenation (PbtO2) catheters and received at least one RBCT.InterventionPatients received at least one RBCT. PbtO2 was recorded before, 1 hour, and 2 hours after RBCT.Measurements And Main ResultsWe included 69 patients receiving a total of 109 RBCTs after a median of 9 days (5-13 d) after injury. Baseline hemoglobin (Hb) and PbtO2 were 7.9 g/dL [7.3-8.7 g/dL] and 21 mm Hg (16-26 mm Hg), respectively; 2 hours after RBCT, the median absolute Hb and PbtO2 increases from baseline were 1.2 g/dL [0.8-1.8 g/dL] (p = 0.001) and 3 mm Hg (0-6 mm Hg) (p = 0.001). A 20% increase in PbtO2 after RBCT was observed in 45 transfusions (41%). High heart rate (HR) and low PbtO2 at baseline were independently associated with a 20% increase in PbtO2 after RBCT. Baseline PbtO2 had an area under receiver operator characteristic of 0.73 (95% CI, 0.64-0.83) to predict PbtO2 increase; a PbtO2 of 20 mm Hg had a sensitivity of 58% and a specificity of 73% to predict PbtO2 increase after RBCT.ConclusionsLower PbtO2 values and high HR at baseline could predict a significant increase in brain oxygenation after RBCT.Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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