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Is hemoglobin good for cerebral oxygenation and clinical outcome in acute brain injury?

English, Shane, W.a,b,c; McIntyre, Lauralyna,b,c

Current Opinion in Critical Care: April 2018 - Volume 24 - Issue 2 - p 91–96
doi: 10.1097/MCC.0000000000000485
NEUROSCIENCE: Edited by Marek A. Mirski

Purpose of review The purpose of this review is to highlight the role of hemoglobin in cerebral physiology and pathophysiology. We review the existing as well as recent evidence detailing the effects of red blood cell transfusion on cerebral oxygenation and clinical outcome.

Recent findings Hemoglobin is a key component in oxygen delivery, and thus cerebral oxygenation. Higher hemoglobin levels and red blood cell transfusion are associated with higher cerebral oxygen delivery and decreased cerebral ischemic burden. Recent studies suggest that this may be associated with improved clinical outcomes. However, these results are limited to only a few, small studies and the results have not been consistent. Further studies are required.

Summary Hemoglobin is important for cerebral oxygenation and strategies to minimize anemia should be undertaken. Although higher hemoglobin levels are associated with less cerebral ischemia and better clinical outcome, whether this remains true whenever red blood cell transfusion is used to achieve this result remains unclear.

aClinical Epidemiology Program

bCentre for Transfusion Research, Ottawa Hospital Research Institute

cDepartment of Medicine (Critical Care), University of Ottawa, Ottawa, Canada

Correspondence to Shane W. English, Centre for Practice-Changing Research, The Ottawa Hospital – General Campus, 501 Smyth Road, PO Box 201B, Ottawa, ON K1H 8L6, Canada. Tel: +1 613 737 8899; e-mail:

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