Grant: Project Grant

Acute brain injury from trauma (TBI) or a burst artery in the brain (aSAH) often affects young people (40-60 years), nearly half of whom will die, and a third will have permanent disability. A particular challenge in managing these patients is that the recovering brain is very sensitive to low oxygen delivery and at great risk of further injury (like new strokes). Oxygen delivery is dependent on blood flow and oxygen attached to the red cells within it. Low blood levels (anemia), is very common in these patients, and leads to worse outcomes. It is unclear if giving blood (transfusion) to treat anemia improves otherwise terrible outcomes in acute brain injury because it has never been properly studied. The few studies that exist do not help clinicians with the decisions they must make every day in these patients. The NeurO2 study, is a nested study within two large trials in TBI and aSAH patients respectively (HEMOTION and SAHaRA Trials). These trials are designed to guide clinicians to better understand if maintaining a higher blood level will improve outcomes. In the NeurO2 study, we will monitor (using Near-Infrared Spectroscopy - NIRS) the effects of our intervention on the measure of brain oxygen delivery. We believe that, in adult patients suffering from anemia, a low blood oxygen delivery (as measured by NIRS) is associated with a poor outcome, but could be affected by blood transfusion and may serve as a trigger for when to give blood. The NeurO2 study is a unique opportunity to clarify the clinical use of this technology as a potential tool to guide therapy in the acute brain-injured vulnerable population.