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TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY

TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

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Page 1: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

T R A N S F U S I O N T R I G G E R I N A C U T E B R A I N I N J U R Y

Page 2: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

P H Y S I O L O G Y + L O G I C

Page 3: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

S I M P L E

Page 4: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

DO2 = [1.39 x Hb x SaO2 + (0.003 x PaO2)] x Q

M O R E = M O R E

Page 5: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate
Page 6: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate
Page 7: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate
Page 8: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

T R A N S F U S I O N T R I G G E R I N A C U T E B R A I N I N J U R Y

Page 9: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

L E U K O D E P L E T I O N

Page 10: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

C O N S E R V E

Page 11: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate
Page 12: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

L E U K O D E P L E T I O N

Page 13: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

C O N S E R V E

Page 14: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

T R A N S F U S E i f < 9 0

Page 15: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

W H A T D O E S T H E P R O F E S S O R D O ?

Page 16: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

H(a)emoglobin Target in Acute Brain Injury Professor Simon Finfer

MBBS FAHMS FRCP FRCA FCICM DrMed

[email protected]@icuresearch

Royal North Shore Hospital

Page 17: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

No relevant disclosures

Page 18: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate
Page 19: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

The List.

14/03/2017Transfusion Threshold SMACC Dub 4

• Critical illness.• Cardiac surgery.• Upper GI bleeding.• PICU.• Septic shock.• Hip surgery in elderly with CV risk. • …………..

Page 20: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

14/03/2017 5

Page 21: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

14/03/2017 6

Page 22: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

The List.

14/03/2017Transfusion Threshold SMACC Dub 7

• Critical illness.• Cardiac surgery.• Upper GI bleeding.• PICU.• Septic shock.• Hip surgery in elderly with CV risk. • Traumatic brain injury.

Page 23: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate
Page 24: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate

https://www.dropbox.com/sh/37k40kdo67pywr6/AAB9UDNYTszGhu_Io53gvbu1a?dl=0

Page 25: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate
Page 26: TRANSFUSION TRIGGER IN ACUTE BRAIN INJURY · More aggressive transfusion may also limit the availability of a scarce resource. It is possible that different thresholds may be appropriate