SynthesisEuropean journal of medical research2025
Red blood cell transfusion strategy in traumatic brain injury patients: a systematic review and meta-analysis.
Synthesis in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The Impact of Hemoglobin Transfusion Thresholds in Moderate-to-Severe Blunt Traumatic Brain Injury on 6-Month Neurologic Outcomes: A Systematic Review and Meta-Analysis.Neurology international · 2026Article
- Effect of head injury on blood transfusion requirements in severe trauma: a post-hoc analysis of the RESTRIC trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Correlation between perioperative red blood cell transfusion strategy and 3-month neurological outcomes in patients undergoing craniotomy for traumatic brain injury.American journal of translational research · 2026Article
- The normative modelling framework for traumatic brain injury.Brain : a journal of neurology · 2025Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundThe optimal red blood cell transfusion (RBCT) strategy for traumatic brain injury (TBI) patients remains a topic of debate. This systematic review and meta-analysis aimed to compare the outcomes of a liberal transfusion strategy versus a restrictive strategy in critically ill patients with TBI.
methodsPubMed, Web of Science, Embase, and Cochrane Library were searched from inception to November 17, 2024. We included randomized controlled trials (RCTs) of critically ill adult patients with TBI, reporting data on RBCT strategies. The outcomes included intensive care unit (ICU) mortality, long-term mortality, unfavorable functional outcomes, and the incidence of adverse events, such as transfused acute respiratory distress syndrome (TARDS) and venous thromboembolism. We also performed subgroup analyses comparing the association between disease severity and long-term mortality. This review was submitted to PROSPERO (Registration number: CRD42024558797).
resultsIn the results, our analysis revealed that compared to a restrictive transfusion strategy, a liberal strategy did not significantly reduce the risk of ICU mortality (RR: 0.74; 95% CI 0.28-1.91; P = 0.53) and long-term mortality (RR: 1.02; 95% CI 0.83-1.25; P = 0.87), but it was able to reduce the risk of unfavorable functional outcomes (RR: 0.90; 95% CI 0.82-0.98; P = 0.01), although there may be a false positive error. In addition, the liberal transfusion strategy was associated with a higher incidence of Transfused Acute Respiratory Distress Syndrome (TARDS) (RR: 1.78; 95% CI 1.06-2.98; P = 0.03).
conclusionsIn critically ill patients with TBI, a liberal RBCT strategy appears to improve functional outcomes but carries the risk of false positive errors. In addition, this strategy does not seem to improve survival and may increase the risk of TARDS. Despite this, there remains insufficient evidence to recommend either strategy in this population.
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