Neuroanesthesia & neurocritical care

Liberal vs. restrictive transfusion strategy for acute brain injury: A meta-analysis with trial sequential analysis of randomized clinical trials

Anaesth Crit Care Pain MedPublished Systematic review and meta-analysis of randomised trials

An erratum to this article was published (Anaesth Crit Care Pain Med, Sep 2026 ↗)

Pooled resultResult — go to the resultRelative risk 0.97 95% CI 0.83–1.14

Authors' conclusion

In patients with acute brain injury, a restrictive transfusion strategy was not associated with worse neurological outcomes or higher mortality compared to a liberal strategy.

Study context

Population
Adults with acute brain injury
Participants
2,599 adults · 6 randomized controlled trials (RCTs)
Comparison
Liberal vs restrictive RBC transfusion strategy
Outcome
Unfavorable neurological outcome
Methodological detailstrial sequential analysis
  • Trial sequential analysis

Pooled result

As reported in the abstract

Relative risk

0.97

95% CI 0.83–1.14

P = 0.70

Liberal vs Restrictive
RR 0.97 (95% CI 0.83–1.14); P = 0.70

Safety

OutcomeRR (95% CI)P value
Transfusion reactionNon-significantly more frequent with liberal transfusion1.13 (0.35–3.58)P = 0.84

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Liberal vs. restrictive transfusion strategy for acute brain injury: A meta-analysis with trial sequential analysis of randomized clinical trials. Anaesth Crit Care Pain Med. Published 13 June 2025. doi:10.1016/j.accpm.2025.101566

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