The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury
Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, a...
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Gespeichert in:
| Autor*in: |
Sekhon, Mypinder S. [verfasserIn] Griesdale, Donald E. [verfasserIn] Czosnyka, Marek [verfasserIn] Donnelly, Joseph [verfasserIn] Liu, Xia [verfasserIn] Aries, Marcel J. [verfasserIn] Robba, Chiara [verfasserIn] Lavinio, Andrea [verfasserIn] Menon, David K. [verfasserIn] Smielewski, Peter [verfasserIn] Gupta, Arun K. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2015 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Neurocritical care - New York, NY : Springer, 2004, 23(2015), 2 vom: 18. Apr., Seite 210-216 |
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| Übergeordnetes Werk: |
volume:23 ; year:2015 ; number:2 ; day:18 ; month:04 ; pages:210-216 |
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| DOI / URN: |
10.1007/s12028-015-0141-x |
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| Katalog-ID: |
SPR023811773 |
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| 100 | 1 | |a Sekhon, Mypinder S. |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury |
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| 520 | |a Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. | ||
| 650 | 4 | |a Vascular reactivity |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Cerebral blood flow |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Autoregulation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Traumatic brain injury |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Pressure reactivity index |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Griesdale, Donald E. |e verfasserin |4 aut | |
| 700 | 1 | |a Czosnyka, Marek |e verfasserin |4 aut | |
| 700 | 1 | |a Donnelly, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xia |e verfasserin |4 aut | |
| 700 | 1 | |a Aries, Marcel J. |e verfasserin |4 aut | |
| 700 | 1 | |a Robba, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Lavinio, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Menon, David K. |e verfasserin |4 aut | |
| 700 | 1 | |a Smielewski, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Arun K. |e verfasserin |4 aut | |
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10.1007/s12028-015-0141-x doi (DE-627)SPR023811773 (SPR)s12028-015-0141-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Sekhon, Mypinder S. verfasserin aut The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. Vascular reactivity (dpeaa)DE-He213 Cerebral blood flow (dpeaa)DE-He213 Autoregulation (dpeaa)DE-He213 Traumatic brain injury (dpeaa)DE-He213 Pressure reactivity index (dpeaa)DE-He213 Griesdale, Donald E. verfasserin aut Czosnyka, Marek verfasserin aut Donnelly, Joseph verfasserin aut Liu, Xia verfasserin aut Aries, Marcel J. verfasserin aut Robba, Chiara verfasserin aut Lavinio, Andrea verfasserin aut Menon, David K. verfasserin aut Smielewski, Peter verfasserin aut Gupta, Arun K. verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 23(2015), 2 vom: 18. Apr., Seite 210-216 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:23 year:2015 number:2 day:18 month:04 pages:210-216 https://dx.doi.org/10.1007/s12028-015-0141-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 23 2015 2 18 04 210-216 |
| spelling |
10.1007/s12028-015-0141-x doi (DE-627)SPR023811773 (SPR)s12028-015-0141-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Sekhon, Mypinder S. verfasserin aut The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. Vascular reactivity (dpeaa)DE-He213 Cerebral blood flow (dpeaa)DE-He213 Autoregulation (dpeaa)DE-He213 Traumatic brain injury (dpeaa)DE-He213 Pressure reactivity index (dpeaa)DE-He213 Griesdale, Donald E. verfasserin aut Czosnyka, Marek verfasserin aut Donnelly, Joseph verfasserin aut Liu, Xia verfasserin aut Aries, Marcel J. verfasserin aut Robba, Chiara verfasserin aut Lavinio, Andrea verfasserin aut Menon, David K. verfasserin aut Smielewski, Peter verfasserin aut Gupta, Arun K. verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 23(2015), 2 vom: 18. Apr., Seite 210-216 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:23 year:2015 number:2 day:18 month:04 pages:210-216 https://dx.doi.org/10.1007/s12028-015-0141-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 23 2015 2 18 04 210-216 |
| allfields_unstemmed |
10.1007/s12028-015-0141-x doi (DE-627)SPR023811773 (SPR)s12028-015-0141-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Sekhon, Mypinder S. verfasserin aut The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. Vascular reactivity (dpeaa)DE-He213 Cerebral blood flow (dpeaa)DE-He213 Autoregulation (dpeaa)DE-He213 Traumatic brain injury (dpeaa)DE-He213 Pressure reactivity index (dpeaa)DE-He213 Griesdale, Donald E. verfasserin aut Czosnyka, Marek verfasserin aut Donnelly, Joseph verfasserin aut Liu, Xia verfasserin aut Aries, Marcel J. verfasserin aut Robba, Chiara verfasserin aut Lavinio, Andrea verfasserin aut Menon, David K. verfasserin aut Smielewski, Peter verfasserin aut Gupta, Arun K. verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 23(2015), 2 vom: 18. Apr., Seite 210-216 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:23 year:2015 number:2 day:18 month:04 pages:210-216 https://dx.doi.org/10.1007/s12028-015-0141-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 23 2015 2 18 04 210-216 |
| allfieldsGer |
10.1007/s12028-015-0141-x doi (DE-627)SPR023811773 (SPR)s12028-015-0141-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Sekhon, Mypinder S. verfasserin aut The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. Vascular reactivity (dpeaa)DE-He213 Cerebral blood flow (dpeaa)DE-He213 Autoregulation (dpeaa)DE-He213 Traumatic brain injury (dpeaa)DE-He213 Pressure reactivity index (dpeaa)DE-He213 Griesdale, Donald E. verfasserin aut Czosnyka, Marek verfasserin aut Donnelly, Joseph verfasserin aut Liu, Xia verfasserin aut Aries, Marcel J. verfasserin aut Robba, Chiara verfasserin aut Lavinio, Andrea verfasserin aut Menon, David K. verfasserin aut Smielewski, Peter verfasserin aut Gupta, Arun K. verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 23(2015), 2 vom: 18. Apr., Seite 210-216 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:23 year:2015 number:2 day:18 month:04 pages:210-216 https://dx.doi.org/10.1007/s12028-015-0141-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 23 2015 2 18 04 210-216 |
| allfieldsSound |
10.1007/s12028-015-0141-x doi (DE-627)SPR023811773 (SPR)s12028-015-0141-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Sekhon, Mypinder S. verfasserin aut The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. Vascular reactivity (dpeaa)DE-He213 Cerebral blood flow (dpeaa)DE-He213 Autoregulation (dpeaa)DE-He213 Traumatic brain injury (dpeaa)DE-He213 Pressure reactivity index (dpeaa)DE-He213 Griesdale, Donald E. verfasserin aut Czosnyka, Marek verfasserin aut Donnelly, Joseph verfasserin aut Liu, Xia verfasserin aut Aries, Marcel J. verfasserin aut Robba, Chiara verfasserin aut Lavinio, Andrea verfasserin aut Menon, David K. verfasserin aut Smielewski, Peter verfasserin aut Gupta, Arun K. verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 23(2015), 2 vom: 18. Apr., Seite 210-216 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:23 year:2015 number:2 day:18 month:04 pages:210-216 https://dx.doi.org/10.1007/s12028-015-0141-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 23 2015 2 18 04 210-216 |
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Enthalten in Neurocritical care 23(2015), 2 vom: 18. Apr., Seite 210-216 volume:23 year:2015 number:2 day:18 month:04 pages:210-216 |
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Vascular reactivity Cerebral blood flow Autoregulation Traumatic brain injury Pressure reactivity index |
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Sekhon, Mypinder S. @@aut@@ Griesdale, Donald E. @@aut@@ Czosnyka, Marek @@aut@@ Donnelly, Joseph @@aut@@ Liu, Xia @@aut@@ Aries, Marcel J. @@aut@@ Robba, Chiara @@aut@@ Lavinio, Andrea @@aut@@ Menon, David K. @@aut@@ Smielewski, Peter @@aut@@ Gupta, Arun K. @@aut@@ |
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Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. 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Sekhon, Mypinder S. |
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Sekhon, Mypinder S. ddc 610 bkl 44.90 misc Vascular reactivity misc Cerebral blood flow misc Autoregulation misc Traumatic brain injury misc Pressure reactivity index The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury |
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Sekhon, Mypinder S. |
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610 ASE 44.90 bkl The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury Vascular reactivity (dpeaa)DE-He213 Cerebral blood flow (dpeaa)DE-He213 Autoregulation (dpeaa)DE-He213 Traumatic brain injury (dpeaa)DE-He213 Pressure reactivity index (dpeaa)DE-He213 |
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ddc 610 bkl 44.90 misc Vascular reactivity misc Cerebral blood flow misc Autoregulation misc Traumatic brain injury misc Pressure reactivity index |
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ddc 610 bkl 44.90 misc Vascular reactivity misc Cerebral blood flow misc Autoregulation misc Traumatic brain injury misc Pressure reactivity index |
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The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury |
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The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury |
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Sekhon, Mypinder S. |
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Neurocritical care |
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Sekhon, Mypinder S. Griesdale, Donald E. Czosnyka, Marek Donnelly, Joseph Liu, Xia Aries, Marcel J. Robba, Chiara Lavinio, Andrea Menon, David K. Smielewski, Peter Gupta, Arun K. |
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Sekhon, Mypinder S. |
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10.1007/s12028-015-0141-x |
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effect of red blood cell transfusion on cerebral autoregulation in patients with severe traumatic brain injury |
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The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury |
| abstract |
Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. |
| abstractGer |
Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. |
| abstract_unstemmed |
Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. Conclusion RBC transfusion in severe TBI patients results in worsening PRx, indicating impaired cerebral autoregulation. |
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The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury |
| url |
https://dx.doi.org/10.1007/s12028-015-0141-x |
| remote_bool |
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| author2 |
Griesdale, Donald E. Czosnyka, Marek Donnelly, Joseph Liu, Xia Aries, Marcel J. Robba, Chiara Lavinio, Andrea Menon, David K. Smielewski, Peter Gupta, Arun K. |
| author2Str |
Griesdale, Donald E. Czosnyka, Marek Donnelly, Joseph Liu, Xia Aries, Marcel J. Robba, Chiara Lavinio, Andrea Menon, David K. Smielewski, Peter Gupta, Arun K. |
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| doi_str |
10.1007/s12028-015-0141-x |
| up_date |
2024-07-03T21:32:49.706Z |
| _version_ |
1803595147858935808 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR023811773</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519085118.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201006s2015 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s12028-015-0141-x</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR023811773</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12028-015-0141-x-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.90</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Sekhon, Mypinder S.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="4"><subfield code="a">The Effect of Red Blood Cell Transfusion on Cerebral Autoregulation in Patients with Severe Traumatic Brain Injury</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2015</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Red blood cell (RBC) transfusion is associated with inconsistent changes in brain tissue oxygenation ($ PbO_{2} $). Previous studies have failed to consider alterations in cerebral autoregulation. Our objective was to investigate the effect of RBC transfusion on cerebral autoregulation, as measured by pressure reactivity index (PRx). Methods Retrospective analysis of 28 severe traumatic brain injury (TBI) patients from a prospective registry between 2007 and 2014. We recorded hemoglobin (Hb) concentration, intracranial pressure, $ PbO_{2} $, cerebral perfusion pressure, PRx, and cerebral lactate/pyruvate ratio for 6 h before and after RBC transfusion. We also recorded body temperature, $ PaO_{2} $, $ PCO_{2} $, pH, and fraction of inspired oxygen. Subgroups of normoxia ($ PbO_{2} $ >20 mmHg) and hypoxia ($ PbO_{2} $ <20 mmHg) prior to transfusion were defined a priori. Results The median age was 36 years [interquartile range (IQR) 27–49], 32 % were female. The median admission Glasgow Coma score was 5 (IQR 4–9) and injury severity score was 16 (IQR 9–21). Overall, mean Hb concentration [80 g/L (SD 7) to 89 g/L (SD 8), p < 0.001] and $ PbO_{2} $ increased [23.5 mmHg (SD 8) to 25.0 mmHg (SD 9), p = 0.033] following transfusion. PRx increased post-transfusion [0.028 (SD 0.29) to 0.11 (SD 0.24), p = 0.034], indicating worsening cerebrovascular pressure reactivity. In patients with mean $ PbO_{2} $ >20 mmHg pre-transfusion (n = 20), the PRx increased significantly [−0.052 (SD 0.24) to 0.079 (SD 0.22), p = 0.007] but did not change in patients with $ PbO_{2} $ <20 mmHg: PRx [0.22 (SD 0.34) to 0.18 (SD 0.30), p = 0.36]. 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