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Br J Anaesth. 2018 May;120(5):988-998. doi: 10.1016/j.bja.2017.11.108. Epub 2018 Feb 2.

Anaemia and red blood cell transfusion in intracranial neurosurgery: a comprehensive review.

Author information

1
Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada.
2
Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA.
3
Department of Anesthesiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA.
4
Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada. Electronic address: alana.flexman@vch.ca.

Abstract

Both anaemia and blood transfusion are associated with poor outcomes in the neurosurgical population. Based on the available literature, the optimal haemoglobin concentration for neurologically injured patients appears to be in the range of 9.0-10.0 g dl-1, although the individual risks and benefits should be weighed. Several perioperative blood conservation strategies have been used successfully in neurosurgery, including correction of anaemia and coagulopathy, use of antifibrinolytics, and intraoperative cell salvage. Avoidance of non-steroidal anti-inflammatory drugs and starch-containing solutions is recommended given the potential for platelet dysfunction.

KEYWORDS:

anaemia; coagulation; neurosurgery; transfusion

PMID:
29661416
DOI:
10.1016/j.bja.2017.11.108

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