Desenlace funcional y hemoglobina en pacientes neurocríticos con hemorragia subaracnoidea a 2600 msnm

Abstract

Introduction: subarachnoid hemorrhage (SAH) is a devastating pathology of the central nervous system, with high morbidity and mortality. Clinical trials of pharmacological therapies may not be affected by the patient's geographic location, particularly by height as therapy with blood products whose relationship with atmospheric pressure and oxygen transport generates areas of uncertainty in cities of higher altitude. Objective: To evaluate the relationship of favorable neurological functional outcome (modified Rankin <3) vs. unfavorable (modified Rankin  4) with a cut-off point of 10 gr / dl hemoglobin prior to transfusion in patients diagnosed with subarachnoid hemorrhage, hospitalized in the neurocritical care unit of the Santa Fe de Bogotá Foundation at 2600 ms. n. m. Methodology: Retrospective observational study of cases and controls based on a historical cohort of patients with SAH, from January 2010 to December 2018 in the Neurological Intensive Care Unit. Results: No relationship was found between favorable functional outcome and transfusion with hemoglobin level with cut-off point of 10 gr / dL OR 1,111 (p = 0.865 95% CI 0.328 - 3.755) Conclusion: A favorable or unfavorable association between the hemoglobin cut-off point and the functional neurological outcome was not demonstrated, it is not possible to make a recommendation against the transfusion threshold. No deleterious effect of blood transfusion was evident, no increase in episodes of spasm vessel or late cerebral ischemia.