tailieunhanh - Báo cáo y học: " Anaemia and its treatment in neurologically critically ill patients: being reasonable is easy without prospective trials"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Anaemia and its treatment in neurologically critically ill patients: being reasonable is easy without prospective trials. | Naidech Critical Care 2010 14 149 http content 14 3 149 CRITICAL CARE COMMENTARY L__ Anaemia and its treatment in neurologically critically ill patients being reasonable is easy without prospective trials Andrew M Naidech See related research by Diedler etal. http content 14 2 R63 Abstract Most healthy humans have a haemoglobin concentration of 12 to 15 g dL and most intensivists now transfuse packed red blood cells for haemoglobin 7 g dL. Higher haemoglobin is associated with improved intermediate and clinical outcomes after subarachnoid hemorrhage from ruptured brain aneurysm or neurotrauma. An observational study in a recent issue shows that higher haemoglobin was associated with better functional outcomes in patients with spontaneous intracerebral haemorrhage few patients received a packed red blood cell transfusion so it is not known if that treatment is better than the disease. The mechanism of anaemia s purported impact on outcome is unclear although altered metabolism in brain tissue that is sensitive to reduced oxygen delivery is plausible. These data may intensify the differences of opinion between intensivists whether neurologic patients are better served by higher haemoglobin and potentially by more packed red blood cell transfusion or simply need to be studied more in prospective clinical trials remains unclear. Introduction The previous issue of Critical Care contains a report associating more severe anaemia with worse outcome after intracerebral haemorrhage. 1 These data are analogous to published reports in subarachnoid hemorrhage and traumatic brain injury that link more severe anaemia with worse outcomes. Anaemia and transfusion in critical illness The traditional goal for packed red blood cell PRBC transfusion was traditionally 10 g dL and revised down Correspondence a-naidech@ Northwestern University Feinberg School of Medicine Department of Neurology 710 N Lake Shore Drive Eleventh Floor Chicago