Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage

In this multicenter, randomized controlled trial involving 742 critically ill adults with aneurysmal subarachnoid hemorrhage and anemia, participants were assigned to either a liberal transfusion strategy (mandatory transfusion if hemoglobin ≤10 g/dL) or a restrictive strategy (transfusion optional at ≤8 g/dL). At 12 months, there was no statistically significant difference in unfavorable neurologic outcomes between the two groups (33.5% vs. 37.7%, respectively). Functional independence, quality of life, and mortality rates were also similar. The findings suggest that a liberal transfusion strategy does not provide a clinical benefit over a restrictive strategy for this patient population.

In this multicenter, randomized controlled trial involving 742 critically ill adults with aneurysmal subarachnoid hemorrhage and anemia, participants were assigned to either a liberal transfusion strategy (mandatory transfusion if hemoglobin ≤10 g/dL) or a restrictive strategy (transfusion optional at ≤8 g/dL). At 12 months, there was no statistically significant difference in unfavorable neurologic outcomes between the two groups (33.5% vs. 37.7%, respectively). Functional independence, quality of life, and mortality rates were also similar. The findings suggest that a liberal transfusion strategy does not provide a clinical benefit over a restrictive strategy for this patient population.