HOT TOPICS: Transfusion Strategies in Acute Brain Injury

In this episode of the NCS Podcast Hot Topics series, host Richard Choi, DO, FNCS, speaks with Katharina Busl, MD, MS, FNCS, division chief of neurocritical care at the University of Florida and assistant editor for Neurocritical Care journal, about transfusion strategies in patients with acute brain injury. They discuss recent randomized trials and a new systematic review examining restrictive versus liberal red blood cell transfusion thresholds across traumatic brain injury, intracerebral hemorrhage and subarachnoid hemorrhage. Their conversation highlights the physiologic rationale behind transfusion, challenges in interpreting trial and meta-analysis data, and how overlapping hemoglobin ranges complicate bedside decision-making. Dr. Busl also shares how this evolving evidence is influencing clinical practice and the importance of individualized transfusion decisions. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.