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Blood Transfusion in Neurosurgery

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Textbook of Neuroanesthesia and Neurocritical Care

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Abstract

Anemia is not safe in both acute and chronic conditions due to its association with a high risk of major organ injury. The highly oxygen-dependent brain is especially prone for hypoxic and ischemic changes which are likely to develop in neurosurgical conditions. New knowledge continues to emerge regarding the cellular mechanisms that maintain oxygen homeostasis during anemia.

The existing treatment modalities of anemia have not produced demons ratable improvement in patient outcome, and the inherent risks associated with transfusion cannot be underestimated. Currently there is no level 1 evidence by which definite transfusion guidelines for neurosurgical patients can be recommended. This chapter combines all the evidence surrounding anemia, transfusion, their effects on clinical outcome in various neurosurgical scenarios, and the possible future directions.

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References

  1. Crippa IA, Lelubre C, Lozano-Roig A, Taccone FS. Optimizing blood transfusion practices in traumatic brain injury and subarachnoid hemorrhage. Curr Anesthesiol Rep. 2016;6(3):250–6.

    Article  Google Scholar 

  2. Bellapart J, Boots R, Fraser J. Physiopathology of anemia and transfusion thresholds in isolated head injury. J Trauma Acute Care Surg. 2012;73(4):997–1005.

    Article  PubMed  Google Scholar 

  3. Sena MJ, Rivers RM, Muizelaar JP, Battistella FD, Utter GH. Transfusion practices for acute traumatic brain injury: a survey of physicians at US trauma centers. Intensive Care Med. 2009;35(3):480–8.

    Article  PubMed  Google Scholar 

  4. Rolston JD, Han SJ, Lau CY, Berger MS, Parsa AT. Frequency and predictors of complications in neurological surgery: national trends from 2006 to 2011. J Neurosurg. 2014;120(3):736–45.

    Article  PubMed  Google Scholar 

  5. Linsler S, Ketter R, Eichler H, Schwerdtfeger K, Steudel WI, Oertel J. Red blood cell transfusion in neurosurgery. Acta Neurochir. 2012;154(7):1303–8.

    Article  PubMed  Google Scholar 

  6. White N, Marcus R, Dover S, Solanki G, Nishikawa H, Millar C, et al. Predictors of blood loss in fronto-orbital advancement and remodeling. J Craniofac Surg. 2009;20(2):378–81.

    Article  PubMed  Google Scholar 

  7. Boutin A, Chasse M, Shemilt M, Lauzier F, Moore L, Zarychanski R, et al. Red blood cell transfusion in patients with traumatic brain injury: a systematic review and meta-analysis. Transfus Med Rev. 2016;30(1):15–24.

    Article  PubMed  Google Scholar 

  8. Epstein DS, Mitra B, O’Reilly G, Rosenfeld JV, Cameron PA. Acute traumatic coagulopathy in the setting of isolated traumatic brain injury: a systematic review and meta-analysis. Injury. 2014;45(5):819–24.

    Article  PubMed  Google Scholar 

  9. Mc Ewen J, Huttunen KH. Transfusion practice in neuroanesthesia. Curr Opin Anesthesiol. 2009;22(5):566–71.

    Article  Google Scholar 

  10. Luostarinen T, Lehto H, Skrifvars MB, Kivisaari R, Niemela M, Hernesniemi J, et al. Transfusion frequency of red blood cells, fresh frozen plasma, and platelets during ruptured cerebral aneurysm surgery. World Neurosurg. 2015;84(2):446–50.

    Article  PubMed  Google Scholar 

  11. Oetgen ME, Litrenta J. Perioperative blood management in pediatric spine surgery. J Am Acad Orthop Surg. 2017;25(7):480–8.

    Article  PubMed  Google Scholar 

  12. Robertson CS, Hannay HJ, Yamal JM, Gopinath S, Goodman JC, Tilley BC, et al. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial. JAMA. 2014;312(1):36–47.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Vedantam A, Yamal JM, Rubin ML, Robertson CS, Gopinath SP. Progressive hemorrhagic injury after severe traumatic brain injury: effect of hemoglobin transfusion thresholds. J Neurosurg. 2016;125(5):1229–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Malone DL, Dunne J, Tracy JK, Putnam AT, Scalea TM, Napolitano LM. Blood transfusion, independent of shock severity, is associated with worse outcome in trauma. J Trauma. 2003;54(5):898–905.

    Article  PubMed  Google Scholar 

  15. Shander A, Goodnough LT. Can blood transfusion be not only ineffective, but also injurious? Ann Thorac Surg. 2014;97(1):11–4.

    Article  PubMed  Google Scholar 

  16. Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med. 2008;36(9):2667–74.

    Article  PubMed  Google Scholar 

  17. Vamvakas EC. Possible mechanisms of allogeneic blood transfusion-associated postoperative infection. Transfus Med Rev. 2002;16(2):144–60.

    Article  PubMed  Google Scholar 

  18. Vamvakas EC, Carven JH. Allogeneic blood transfusion and postoperative duration of mechanical ventilation: effects of red cell supernatant, platelet supernatant, plasma components and total transfused fluid. Vox Sang. 2002;82(3):141–9.

    Article  CAS  PubMed  Google Scholar 

  19. Coleman T, Brines M. Science review: recombinant human erythropoietin in critical illness: a role beyond anemia? Crit Care. 2004;8(5):337–41.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Jian M, Li X, Wang A, Zhang L, Han R, Gelb AW. Flurbiprofen and hypertension but not hydroxyethyl starch are associated with post-craniotomy intracranial haematoma requiring surgery. Br J Anaesth. 2014;113(5):832–9.

    Article  CAS  PubMed  Google Scholar 

  21. Dadure MDPDC, Sauter MDM, Bringuier PDPDS, Bigorre MDM, Raux MDMSO, Rochette MDA, et al. Intraoperative Tranexamic acid reduces blood transfusion in children undergoing Craniosynostosis surgery a randomized double-blind study. Anesthesiology. 2011;114(4):856–61.

    Article  CAS  PubMed  Google Scholar 

  22. Wong J, El Beheiry H, Rampersaud YR, Lewis S, Ahn H, De Silva Y, et al. Tranexamic acid reduces perioperative blood loss in adult patients having spinal fusion surgery. Anesth Analg. 2008;107(5):1479–86.

    Article  PubMed  Google Scholar 

  23. Mebel D, Akagami R, Flexman AM. Use of tranexamic acid is associated with reduced blood product transfusion in complex skull base neurosurgical procedures: a retrospective cohort study. Anesth Analg. 2016;122(2):503–8.

    Article  CAS  PubMed  Google Scholar 

  24. Hooda B, Chouhan RS, Rath GP, Bithal PK, Suri A, Lamsal R. Effect of tranexamic acid on intraoperative blood loss and transfusion requirements in patients undergoing excision of intracranial meningioma. J Clin Neurosci. 2017;41:132–8.

    Article  CAS  PubMed  Google Scholar 

  25. Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013;17(10):1–79.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Baharoglu MI, Germans MR, Rinkel GJ, Algra A, Vermeulen M, van Gijn J, et al. Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2013;8:CD001245.

    Google Scholar 

  27. Willner D, Spennati V, Stohl S, Tosti G, Aloisio S, Bilotta F. Spine surgery and blood loss: systematic review of clinical evidence. Anesth Analg. 2016;123(5):1307–15.

    Article  CAS  PubMed  Google Scholar 

  28. Thompson ME, Saadeh C, Watkins P, Nagy L, Demke J. Blood loss and transfusion requirements with epsilon-aminocaproic acid use during cranial vault reconstruction surgery. J Clin Anesth. 2017;36:153–7.

    Article  CAS  PubMed  Google Scholar 

  29. Naqash I, Draboo M, Lone A, Nengroo S, Kirmani A, Bhat A. Evaluation of acute normovolemic hemodilution and autotransfusion in neurosurgical patients undergoing excision of intracranial meningioma. J Anaesthesiol Clin Pharmacol. 2011;27(1):54–8.

    PubMed  PubMed Central  Google Scholar 

  30. Oppitz PP, Stefani MA. Acute normovolemic hemodilution is safe in neurosurgery. World Neurosurg. 2013;79(5–6):719–24.

    Article  PubMed  Google Scholar 

  31. Cataldi S, Bruder N, Dufour H, Lefevre P, Grisoli F, Francois G. Intraoperative autologous blood transfusion in intracranial surgery. Neurosurgery. 1997;40(4):765–71. discussion 71–2.

    Article  CAS  PubMed  Google Scholar 

  32. Miao YL, Ma HS, Guo WZ, Wu JG, Liu Y, Shi WZ, et al. The efficacy and cost-effectiveness of cell saver use in instrumented posterior correction and fusion surgery for scoliosis in school-aged children and adolescents. Plo S One. 2014;9(4):e92997.

    Article  CAS  Google Scholar 

  33. Kumar N, Zaw AS, Khoo BL, Nandi S, Lai Z, Singh G, et al. Intraoperative cell salvage in metastatic spine tumour surgery reduces potential for reinfusion of viable cancer cells. Eur Spine J. 2016;25(12):4008–15.

    Article  PubMed  Google Scholar 

  34. Epstein NE. Tisseel does not reduce postoperative drainage, length of stay, and transfusion requirements for lumbar laminectomy with noninstrumented fusion versus laminectomy alone. Surg Neurol Int. 2015;6(Suppl 4):S172–S6.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Raw DA, Beattie JK, Hunter JM. Anaesthesia for spinal surgery in adults. Br J Anaesth. 2003;91(6):886–904.

    Article  CAS  PubMed  Google Scholar 

  36. Koh JC, Lee JS, Han DW, Choi S, Chang CH. Increase in airway pressure resulting from prone position patient placing may predict intraoperative surgical blood loss. Spine. 2013;38(11):E678–82.

    Article  PubMed  Google Scholar 

  37. Surve RM, Muthuchellappan R, Rao GS, Philip M. The effect of blood transfusion on central venous oxygen saturation in critically ill patients admitted to a neurointensive care unit. Transfus Med. 2016;26(5):343–8.

    Article  CAS  PubMed  Google Scholar 

  38. Dueck MH, Klimek M, Appenrodt S, Weigand C, Boerner U. Trends but not individual values of central venous oxygen saturation agree with mixed venous oxygen saturation during varying hemodynamic conditions. Anesthesiology. 2005;103(2):249–57.

    Article  PubMed  Google Scholar 

  39. Mazza BF, Freitas FGR, Barros MMO, Azevedo LCP, Machado FR. Blood transfusions in septic shock: is 7.0g/dL really the appropriate threshold? Rev Bras Ter Intensiv. 2015;27(1):36–43.

    Article  Google Scholar 

  40. Haas T, Spielmann N, Mauch J, Madjdpour C, Speer O, Schmugge M, et al. Comparison of thromboelastometry (ROTEM (R)) with standard plasmatic coagulation testing in paediatric surgery. Br J Anaesth. 2012;108(1):36–41.

    Article  CAS  PubMed  Google Scholar 

  41. Awada WN, Mohmoued MF, Radwan TM, Hussien GZ, Elkady HW. Continuous and noninvasive hemoglobin monitoring reduces red blood cell transfusion during neurosurgery: a prospective cohort study. J Clin Monit Comput. 2015;29(6):733–40.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Cem A, Serpil UO, Fevzi T, Murat O, Umit G, Esin E, et al. Efficacy of near-infrared spectrometry for monitoring the cerebral effects of severe dilutional anemia. Heart Surg Forum. 2014;17(3):E154–9.

    Article  PubMed  Google Scholar 

  43. Green DW. A retrospective study of changes in cerebral oxygenation using a cerebral oximeter in older patients undergoing prolonged major abdominal surgery. Eur J Anaesthesiol. 2007;24(3):230–4.

    Article  CAS  PubMed  Google Scholar 

  44. Terborg C, Groschel K, Petrovitch A, Ringer T, Schnaudigel S, Witte OW, et al. Noninvasive assessment of cerebral perfusion and oxygenation in acute ischemic stroke by near-infrared spectroscopy. Eur Neurol. 2009;62(6):338–43.

    Article  CAS  PubMed  Google Scholar 

  45. Schoon P, Benito Mori L, Orlandi G, Larralde C, Radrizzani M. Incidence of intracranial hypertension related to jugular bulb oxygen saturation disturbances in severe traumatic brain injury patients. Acta Neurochir Suppl. 2002;81:285–7.

    CAS  PubMed  Google Scholar 

  46. Oddo M, Levine JM, Kumar M, Iglesias K, Frangos S, Maloney-Wilensky E, et al. Anemia and brain oxygen after severe traumatic brain injury. Intensive Care Med. 2012;38(9):1497–504.

    Article  CAS  PubMed  Google Scholar 

  47. Hare GM, Tsui AK, McLaren AT, Ragoonanan TE, Yu J, Mazer CD. Anemia and cerebral outcomes: many questions, fewer answers. Anesth Analg. 2008;107(4):1356–70.

    Article  PubMed  Google Scholar 

  48. Warner MA, O’Keeffe T, Bhavsar P, Shringer R, Moore C, Harper C, et al. Transfusions and long-term functional outcomes in traumatic brain injury. J Neurosurg. 2010;113(3):539–46.

    Article  CAS  PubMed  Google Scholar 

  49. Carlson AP, Schermer CR, Lu SW. Retrospective evaluation of anemia and transfusion in traumatic brain injury. J Trauma. 2006;61(3):567–71.

    Article  PubMed  Google Scholar 

  50. Salim A, Hadjizacharia P, DuBose J, Brown C, Inaba K, Chan L, et al. Role of anemia in traumatic brain injury. J Am Coll Surg. 2008;207(3):398–406.

    Article  PubMed  Google Scholar 

  51. Smith MJ, Stiefel MF, Magge S, Frangos S, Bloom S, Gracias V, et al. Packed red blood cell transfusion increases local cerebral oxygenation. Crit Care Med. 2005;33(5):1104–8.

    Article  PubMed  Google Scholar 

  52. Kramer AH, Diringer MN, Suarez JI, Naidech AM, Macdonald LR, Le Roux PD. Red blood cell transfusion in patients with subarachnoid hemorrhage: a multidisciplinary north American survey. Crit Care. 2011;15(1):R30.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Nichol A, French C, Little L, Haddad S, Presneill J, Arabi Y, et al. Erythropoietin in traumatic brain injury (EPO-TBI): a double-blind randomised controlled trial. Lancet. 2015;386(10012):2499–506.

    Article  CAS  PubMed  Google Scholar 

  54. Festic E, Rabinstein AA, Freeman WD, Mauricio EA, Robinson MT, Mandrekar J, et al. Blood transfusion is an important predictor of hospital mortality among patients with aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2013;18(2):209–15.

    Article  PubMed  Google Scholar 

  55. Rosenberg NF, Koht A, Naidech AM. Anemia and transfusion after aneurysmal subarachnoid hemorrhage. J Neurosurg Anesthesiol. 2013;25(1):66–74.

    Article  PubMed  Google Scholar 

  56. Le Roux PD. Anemia and transfusion after subarachnoid hemorrhage. Neurocrit Care. 2011;15(2):342–53.

    Article  PubMed  Google Scholar 

  57. Naidech AM, Jovanovic B, Wartenberg KE, Parra A, Ostapkovich N, Connolly ES, et al. Higher hemoglobin is associated with improved outcome after subarachnoid hemorrhage. Crit Care Med. 2007;35(10):2383–9.

    Article  CAS  PubMed  Google Scholar 

  58. Pluta RM, Hansen-Schwartz J, Dreier J, Vajkoczy P, Macdonald RL, Nishizawa S, et al. Cerebral vasospasm following subarachnoid hemorrhage: time for a new world of thought. Neurol Res. 2009;31(2):151–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Mayer SA, Lin J, Homma S, Solomon RA, Lennihan L, Sherman D, et al. Myocardial injury and left ventricular performance after subarachnoid hemorrhage. Stroke. 1999;30(4):780–6.

    Article  CAS  PubMed  Google Scholar 

  60. English SW, Fergusson D, Chassé M, Turgeon AF, Lauzier F, Griesdale D, et al. Aneurysmal sub arachnoid hemorrhage—red blood cell transfusion and outcome (SAHaRA): a pilot randomised controlled trial protocol. BMJ Open. 2016;6(12):e012623.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Diringer MN, Bleck TP, Claude Hemphill J 3rd, Menon D, Shutter L, Vespa P, et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical care Society’s multidisciplinary consensus conference. Neurocrit Care. 2011;15(2):211–40.

    Article  PubMed  Google Scholar 

  62. Wu W-C, Trivedi A, Friedmann PD, Henderson WG, Smith TS, Poses RM, et al. Association between hospital intraoperative blood transfusion practices for surgical blood loss and hospital surgical mortality rates. Ann Surg. 2012;255(4):708–14.

    Article  PubMed  Google Scholar 

  63. Rogers L, Zhang P, Vogelbaum M, Perry A, Ashby LS, Modi J, et al. Mngi-08. High-risk meningioma: initial outcomes from Nrg oncology/Rtog-0539. Neuro-Oncology. 2017;19(suppl_6):vi133.

    Article  PubMed Central  Google Scholar 

  64. Atzil S, Arad M, Glasner A, Abiri N, Avraham R, Greenfeld K, et al. Blood transfusion promotes cancer progression: a critical role for aged erythrocytes. Anesthesiology. 2008;109(6):989–97.

    Article  PubMed  Google Scholar 

  65. Alkhalid Y, Lagman C, Sheppard JP, Nguyen T, Prashant GN, Ziman AF, et al. Restrictive transfusion threshold is safe in high-risk patients undergoing brain tumor surgery. Clin Neurol Neurosurg. 2017;163:103–7.

    Article  PubMed  Google Scholar 

  66. Hu SS. Blood loss in adult spinal surgery. Eur Spine J. 2004;13(Suppl 1):S3–5.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Zheng F, Cammisa FP Jr, Sandhu HS, Girardi FP, Khan SN. Factors predicting hospital stay, operative time, blood loss, and transfusion in patients undergoing revision posterior lumbar spine decompression, fusion, and segmental instrumentation. Spine. 2002;27(8):818–24.

    Article  PubMed  Google Scholar 

  68. Master DL, Son-Hing JP, Poe-Kochert C, Armstrong DG, Thompson GH. Risk factors for major complications after surgery for neuromuscular scoliosis. Spine. 2011;36(7):564–71.

    Article  PubMed  Google Scholar 

  69. Stern S, Rice J, Philbin N, McGwin G, Arnaud F, Johnson T, et al. Resuscitation with the hemoglobin-based oxygen carrier, HBOC-201, in a swine model of severe uncontrolled hemorrhage and traumatic brain injury. Shock (Augusta, Ga). 2009;31(1):64–79.

    Article  CAS  Google Scholar 

  70. Janssen SJ, Braun Y, Wood KB, Cha TD, Schwab JH. Allogeneic blood transfusions and postoperative infections after lumbar spine surgery. Spine J. 2015;15(5):901–9.

    Article  PubMed  Google Scholar 

  71. Guay J. The effect of neuraxial blocks on surgical blood loss and blood transfusion requirements: a meta-analysis. J Clin Anesth. 2006;18(2):124–8.

    Article  PubMed  Google Scholar 

  72. Vassal O, Desgranges FP, Tosetti S, Burgal S, Dailler F, Javouhey E, et al. Risk factors for intraoperative allogeneic blood transfusion during craniotomy for brain tumor removal in children. Paediatr Anaesth. 2016;26(2):199–206.

    Article  PubMed  Google Scholar 

  73. Nguyen TT, Hill S, Austin TM, Whitney GM, Wellons JC 3rd, Lam HV. Use of blood-sparing surgical techniques and transfusion algorithms: association with decreased blood administration in children undergoing primary open craniosynostosis repair. J Neurosurg Pediatr. 2015;31:1–8.

    Google Scholar 

  74. Vega RA, Lyon C, Kierce JF, Tye GW, Ritter AM, Rhodes JL. Minimizing transfusion requirements for children undergoing craniosynostosis repair: the CHoR protocol. J Neurosurg Pediatr. 2014;14(2):190–5.

    Article  PubMed  Google Scholar 

  75. Vitale MG, Levy DE, Park MC, Choi H, Choe JC, Roye DP Jr. Quantifying risk of transfusion in children undergoing spine surgery. Spine J. 2002;2(3):166–72.

    Article  PubMed  Google Scholar 

  76. Lavoie J. Blood transfusion risks and alternative strategies in pediatric patients. Paediatr Anaesth. 2011;21(1):14–24.

    Article  PubMed  Google Scholar 

  77. Kuramatsu JB, Gerner ST, Lücking H, Kloska SP, Schellinger PD, Köhrmann M, et al. Anemia is an independent prognostic factor in intracerebral hemorrhage: an observational cohort study. Crit Care. 2013;17(4):R148.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Diedler J, Sykora M, Hahn P, Heerlein K, Schölzke MN, Kellert L, et al. Low hemoglobin is associated with poor functional outcome after non-traumatic, supratentorial intracerebral hemorrhage. Crit Care. 2010;14(2):R63.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Sheth KN, Gilson AJ, Chang Y, Kumar MA, Rahman RM, Rost NS, et al. Packed red blood cell transfusion and decreased mortality in intracerebral hemorrhage. Neurosurgery. 2011;68(5):1286–92.

    Article  PubMed  Google Scholar 

  80. Frontera JA, Lewin JJ 3rd, Rabinstein AA, Aisiku IP, Alexandrov AW, Cook AM, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: a statement for healthcare professionals from the neurocritical care society and society of critical care medicine. Neurocrit Care. 2016;24(1):6–46.

    Article  CAS  PubMed  Google Scholar 

  81. Kellert L, Martin E, Sykora M, Bauer H, Gussmann P, Diedler J, et al. Cerebral oxygen transport failure?: decreasing hemoglobin and hematocrit levels after ischemic stroke predict poor outcome and mortality: STroke: RelevAnt impact of hemoGlobin, hematocrit and transfusion (STRAIGHT)--an observational study. Stroke. 2011;42(10):2832–7.

    Article  CAS  PubMed  Google Scholar 

  82. Maas AI, Menon DK, Steyerberg EW, Citerio G, Lecky F, Manley GT, et al. Collaborative European NeuroTrauma effectiveness research in traumatic brain injury (CENTER-TBI): a prospective longitudinal observational study. Neurosurgery. 2015;76(1):67–80.

    Article  PubMed  Google Scholar 

  83. Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med. 1999;340(6):409–17.

    Article  PubMed  Google Scholar 

  84. Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the management of severe traumatic brain injury. Fourth edition. Neurosurgery. 2017;80(1):6–15.

    PubMed  Google Scholar 

  85. Murphy MF, Estcourt L, Goodnough LT. Blood transfusion strategies in elderly patients. Lancet Haematol. 2017;4(10):e453–e4.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Nizams Institute of Medical Sciences, Hyderabad, India

    Kavitha Jayaram & Shibani Padhy

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  1. Kavitha Jayaram
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  2. Shibani Padhy
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  1. Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India

    Hemanshu Prabhakar

  2. Division of Neuroanesthesiology, Department of Anesthesiology, Sher-i-Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India

    Zulfiqar Ali

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Jayaram, K., Padhy, S. (2019). Blood Transfusion in Neurosurgery. In: Prabhakar, H., Ali, Z. (eds) Textbook of Neuroanesthesia and Neurocritical Care. Springer, Singapore. https://doi.org/10.1007/978-981-13-3387-3_27

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