Does a Higher Hemoglobin Target Improve Outcomes in Aneurysmal Subarachnoid Hemorrhage?

Consistent with a large body of evidence in other critical illnesses, this study does not support a strategy of liberal red blood cell transfusions in aneurysmal subarachnoid hemorrhage.

Aneurysmal subarachnoid hemorrhage (SAH) is a severe and frequently disabling stroke subtype with a relatively high incidence of delayed cerebral ischemia. In order to maximize oxygen delivery to vulnerable neurons, some clinicians use red blood cell (RBC) transfusions to target a higher hemoglobin threshold than the generally recommended transfusion goal of 7.0 g/dL in critical illness. However, RBC transfusion is associated with adverse effects including infection, cardiac overload, and lung injury.

This trial was designed to test whether targeting a hemoglobin value of 10.0 g/dL versus a slightly more restrictive threshold of 8.0 g/dL improves neurologic outcomes in aneurysmal SAH. Adults with aneurysmal SAH and a hemoglobin level <10.0 g…

Reviewing Author

Craig A. Williamson, MD, MS

Disclosures

Consultant/Advisory BoardNational Football League

RoyaltiesUpToDate, Inc.

Grant/Research SupportNational Institutes of Health

Editorial BoardsNeurocritical Care