Blood Transfusion Approach in Patients with Moderate or Severe Traumatic Brain Injury: A Prospective Interventional Study | ||
| Benha Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 23 October 2025 PDF (657.61 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/bmfj.2025.417136.2635 | ||
| Authors | ||
| Sherif Tarek Abdellatif* 1; Ehab A. Abdelrahman2; Engy A. Okab3 | ||
| 1MB.B.Ch Faculty of Medicine, Benha University | ||
| 2Professor of Anesthesia and Intensive Care Faculty of Medicine, Benha University | ||
| 3Lecturer of Critical care medicine Faculty of Medicine, Benha University | ||
| Abstract | ||
| Background: Traumatic brain injury (TBI) is a significant contributor to global morbidity and mortality. Determining optimal hemoglobin (Hb) transfusion thresholds in TBI remains debated due to the brain's vulnerability to anemia. This study investigates the effects of liberal versus restrictive transfusion strategies on survival, neurological recovery, ICU stay, and infectious complications in patients with moderate to severe TBI. Methods: A prospective interventional study was conducted at Benha University Hospitals from October 2024 to March 2025. Sixty patients with moderate (GCS 9–12) or severe (GCS 3–8) TBI and Hb <9.5 g/dL were enrolled. Participants were randomized into Group A (restrictive approach): transfusion for Hb <7.5 g/dL (n=30), and Group B (liberal approach): transfusion for Hb <9.5 g/dL (n=30). Primary outcome was mortality; secondary outcomes included neurological improvement, ICU length of stay, and infection incidence. Results: The liberal transfusion group showed higher survival (73.3% vs. 50%, p=0.041) and greater neurological improvement (73.3% vs. 50%, p=0.037) compared to the restrictive group. Mortality was lower in Group B (26.7% vs. 50%, p=0.041). Moderate TBI cases had survival of 81% in the liberal group versus 70% in the restrictive group, while severe TBI survival was 64% vs. 40%, respectively. Prolonged ICU stay (>7 days) occurred in both groups, but sepsis was more frequent in the restrictive cohort. Conclusion: Implementing a liberal transfusion threshold in moderate to severe TBI is associated with improved survival, neurological recovery, and reduced infectious complications. These results support higher transfusion thresholds as a potential approach to optimize patient outcomes. | ||
| Keywords | ||
| Traumatic Brain Injury; Blood Transfusion Approach; Hemoglobin Threshold; Neurological Recovery; Critical Care Outcomes | ||
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