• Santiago Ramón Leal-Noval, María Dolores Rincón-Ferrari, Ana Marin-Niebla, Aurelio Cayuela, Victoria Arellano-Orden, Antonio Marín-Caballos, Rosario Amaya-Villar, Carmen Ferrándiz-Millón, and Francisco Murillo-Cabeza.
• Neurotrauma Critical Care, Hospital Universitario "Virgen del Rocío", Avda/ Manuel Siurot, s/nr, 41013, Seville, Spain. sramon@cica.es
• Intensive Care Med. 2006 Nov 1;32(11):1733-40.

ObjectiveTo investigate the long-term influence of erythrocyte transfusion on cerebral oxygenation in patients with severe traumatic brain injury.DesignProspective and observational study.SettingNeurotrauma intensive care unit of trauma center level I.PatientsSixty consecutive, hemodynamically stable patients with severe traumatic brain injury, pretransfusion hemoglobin<100g/l, non-bleeding and monitored through intracranial pressure and brain tissue partial pressure of oxygen (PtiO(2)) catheters were included.InterventionsTransfusion of 1-2 units of red blood cells.Measurements And ResultsTen sets of variables (pretransfusion, end of transfusion, and 1, 2, 3, 4, 5, 6, 12 and 24h after transfusion) were recorded, including: PtiO(2), cerebral perfusion pressure (CPP), end-tidal CO(2), peripheral saturation of oxygen, temperature, hemoglobin, lactate and PaO(2)/FiO(2) ratio. Transfusion was associated with an increase in PtiO(2) during a 6-h period, with a peak at 3h (26.2%; p=0.0001) in 78.3% of the patients. No relationship was observed between PtiO(2), CPP and hemoglobin increments. The relative increment in PtiO(2) at hour 3 was only correlated with baseline PtiO(2) (r(2) 0.166; p=0.001). All of the patients with basal PtiO(2)<15mmHg showed an increment in PtiO(2) versus 74.5% of patients with basal PtiO(2)>or=15mmHg (p<0.01, hour 3).ConclusionsErythrocyte transfusion is associated with a variable and prolonged increment of cerebral tissue oxygenation in anemic patients with severe traumatic brain injury. Low baseline PtiO(2) levels (<15mmHg) could define those patients who benefit the most from erythrocyte transfusion.

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