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Randomized trials have shown that a hemoglobin transfusion threshold of <7 g/dL is appropriate for most critically ill patients However, very few patients with acute brain injury were included in those studies, and brain injury can disrupt cerebral autoregulation, which potentially justifies a higher transfusion threshold. In a recent trial of patients with traumatic brain injury, a liberal transfusion strategy produced somewhat better outcomes than a restrictive strategy, although the differences did not reach statistical significance (N Engl J Med 2024; 391:722).
In a new study, investigators enrolled 850 patients with anemia and traumatic brain injury, aneurysmal subarachnoid hemorrhage, or intracranial hemorrhage in 72 intensive care uni…