Neuroanesthesia & neurocritical care

Restrictive transfusion in acute brain injury: A meta-analysis of randomized clinical trials

J Crit CarePublished Systematic review and meta-analysis of randomised trials

Pooled result · Unfavorable neurological outcomeResult — go to the resultRelative risk 1.09 95 % CI 0.99–1.19

Authors' conclusion

Restrictive transfusion may be resource-efficient, but current evidence does not confirm superiority over liberal strategies.

Study context

Population
Critically ill patients with acute brain injury
Participants
2,598 patients · 6 randomized controlled trials (RCTs)
Comparison
Restrictive vs liberal transfusion strategies
  • Restrictiven = 1,307
Outcome
Neurological outcomes (unfavorable neurological outcome)
Methodological detailsrandom-effects model
  • Random-effects model

Pooled result

Unfavorable neurological outcome

Relative risk

1.09

95 % CI 0.99–1.19

Restrictive vs Liberal
RR 1.09 (95 % CI 0.99–1.19)

As reported in the abstract

Further pooled results

OutcomeRR (95 % CI)
All-cause mortality1.021 (0.890–1.172)
OutcomeMD (95 % CI)
RBC transfusions (units per patient)Significantly reduced with restrictive strategy−2.202 ([−2.998]-[−1.406])

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

Original publication

Restrictive transfusion in acute brain injury: A meta-analysis of randomized clinical trials. J Crit Care. Published 16 October 2025. doi:10.1016/j.jcrc.2025.155311

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