Red blood cell transfusion in patients with traumatic brain injury: a systematic review protocol View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-06-18

AUTHORS

Amélie Boutin, Michaël Chassé, Michèle Shemilt, François Lauzier, Lynne Moore, Ryan Zarychanski, Jacques Lacroix, Dean A Fergusson, Philippe Desjardins, Alexis F Turgeon

ABSTRACT

BACKGROUND: Anemia is a prevalent condition in critically ill patients and red blood cell transfusions are frequent. Although transfusions at low hemoglobin levels have been shown to be associated with equivalent or better outcomes than higher hemoglobin thresholds, clinical equipoise persists in patients with traumatic brain injury considering their susceptibility to secondary cerebral insults such as those from hypoxemia. METHODS: Our objectives are to estimate the frequency of red blood cell transfusion in patients with traumatic brain injury and to evaluate transfusion thresholds, determinants and outcomes associated with transfusion strategies.We will conduct a systematic review of cohort studies and randomized controlled trials of patients with traumatic brain injury. We will search MEDLINE, Embase, BIOSIS and the Cochrane Library for eligible studies. Two independent reviewers will screen all identified references. Studies including adult patients with traumatic brain injury reporting data on red blood cell transfusions will be eligible. We will collect data on baseline demographics, trauma characteristics, hemoglobin thresholds, blood transfusions and clinical outcomes (mortality, length of stay, complications, and so on). Two independent reviewers will extract data using a standardized form. We will pool cumulative incidences using DerSimonian and Lair random-effect models after a Freeman-Tukey transformation to stabilize variances. We will pool risk ratios or mean differences with random-effect models and Mantel-Haenszel or inverse variance methods in order to evaluate the association between red blood cell transfusion and potential determinants or outcomes. Sensitivity and subgroup analysis according to timing of red blood cell transfusion, traumatic brain injury severity, year of conduction of the study, risk of bias, notably, are planned. DISCUSSION: We expect to observe high heterogeneity in the proportion of transfused patients across studies and that the global proportion will be similar to the frequency observed in the general medical critically ill population. Our systematic review will allow us to better describe and understand current transfusion practices in patients with traumatic brain injury, a clinical population in which liberal transfusions are still advocated in the absence of evidence-based data. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42014007402. More... »

PAGES

66-66

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/2046-4053-3-66

DOI

http://dx.doi.org/10.1186/2046-4053-3-66

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1014011433

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24943006


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79 injury reporting data
80 injury severity
81 insult
82 inverse variance method
83 levels
84 liberal transfusion
85 library
86 lower hemoglobin levels
87 method
88 model
89 objective
90 order
91 outcomes
92 patients
93 population
94 potential determinants
95 practice
96 prevalent condition
97 proportion
98 protocol
99 random-effects model
100 ratio
101 red blood cell transfusion
102 reference
103 reporting data
104 review
105 review protocol
106 reviewers
107 risk
108 risk of bias
109 risk ratio
110 secondary cerebral insults
111 sensitivity
112 severity
113 standardized form
114 strategies
115 study
116 subgroup analysis
117 susceptibility
118 systematic review
119 systematic review protocol
120 timing
121 transformation
122 transfusion
123 transfusion practice
124 transfusion strategy
125 trauma characteristics
126 traumatic brain injury
127 traumatic brain injury reporting data
128 traumatic brain injury severity
129 trial of patients
130 trials
131 variance
132 variance method
133 year of conduction
134 years
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