Restrictive vs Liberal Transfusion Strategy in Traumatic Brain Injury: A Secondary Analysis of the TRAIN Trial - Takeaways - MDSpire
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Comparative Analysis of Restrictive and Liberal Blood Transfusion Approaches in Patients with Traumatic Brain Injury: Insights from the TRAIN Trial

  • By

  • Irene Sbaraini Zernini

  • Chiara Faso

  • Carla Bittencourt Rynkowski

  • Kirsten Moller

  • Piet Lormans

  • Manuel Quintana Diaz

  • Anselmo Caricato

  • Marjorie Beumier

  • Evy Voets

  • Mario Arias

  • Herve Quintard

  • Diego Morocho

  • Pedro Kurtz

  • Erik Roman Pognuz

  • Olivier Huet

  • Ata Mahmoodpoor

  • Aaron Blandino-Ortiz

  • Sara Alcantara

  • Russell Chabanne

  • Francisco Cicho

  • Stan Popugaev

  • Angelo Giacomucci

  • Jamil Dibu

  • Raphael Cinotti

  • Pierre Bouzat

  • Jean-Louis Vincent

  • Elisa Gouvêa Bogossian

  • Fabio Silvio Taccone

  • TRAIN Study Trial Group

  • Claudia Díaz

  • Andrés Saravia

  • Ahmas Bayrlee

  • Laura Nedolast

  • Hussam Elkambergy

  • Haamid Siddique

  • Jihad Mallat

  • Nahla AlJaberi

  • Samer Shoshan

  • Ayo Mandi

  • Bruno De Oliveira

  • Malligere Prasanna

  • Rehan Haque

  • Dnyaneshwar Munde

  • Sara Chaffee

  • Fatma Alawadhi

  • Eija Junttila

  • Teemu Luoto

  • Simona Šteblaj

  • Jacques Creteur

  • Dominique Durand

  • Caroline Abbenhuijs

  • Nancy Itesa Matumikina

  • Filippo Annoni

  • Leda Nobile

  • Miguel Ulloa Bersatti

  • Igor Yovenko

  • Alexander Tsarev

  • Jasperina Dubois

  • Luc Janssen

  • Luigi Zattera

  • Leire Pedrosa

  • Berta Monleon Lopez

  • Ainhoa Serrano

  • Nekane Romero-García

  • Xavier Wittebole

  • Antonio M Dell'Anna

  • Camilla Gelormini

  • Eleonora Stival

  • Pilar Marcos Neira

  • Regina Roig Pineda

  • Lara Bielsa Berrocal

  • Maite Misis del Campo

  • Stepani Bendel

  • Jorge H Mejía-Mantilla

  • Ángela Marulanda

  • Wojciech Dabrowski

  • Rune Damgaard Nielsen

  • Markus Harboe Olsen

  • Helene Ravnholt Jensen

  • Ida Møller Larsen

  • Roberta Tallarico

  • Umberto Lucangelo

  • Maria Isabel Gonzales Perez

  • Carole Ichai

  • Karim Asenhoune

  • Karim Lakhal

  • Charlotte Fernandez-Canal

  • Samuel Gay

  • Marie Lebouc

  • David Bougon

  • Etienne Escudier

  • Michel Sirodot

  • Albrice Levrat

  • Alix Courouau

  • Jacques Duranteau

  • Aurore Rodrigues

  • Naima Makouche

  • Gilles Francony

  • Olivier Vincent

  • Perrine Boucheix

  • Clotilde Schilte

  • Anais Adolle

  • Thomas Gargadennec

  • Patricia Dias

  • Gwenaelle Desanglois

  • Alexia Meheut

  • Pauline Cam

  • Geert Meyfroidt

  • Liese Mebis

  • Alexandra Hendrickx

  • Pieetr Wouters

  • Sylvia Van Hulle

  • Alain D'Hondt

  • Marc Burgeois

  • Olivier Simonet

  • Frederic Vallot

  • Pablo Centeno

  • Matias Anchorena

  • Ximena Benavente

  • Maximilian D'Onofrio

  • Nydia Funes

  • Antonio Barra de Oca

  • Gabriela Izzo

  • Charlotte Castelain

  • Filippo Soetens

  • Manuel Jabaja

  • Diego Tutillo

  • Celeste Dias

  • Elena Perez Solada

  • Pilar Justo

  • Amparo Lopez Gomez

  • Francisco Chico

  • Maria Fernanda Garcia

  • Fabricio Picoita

  • Stela Velasco Eichler

  • Gabriela Nonticuri Bianchi

  • João Pedro Britz

  • Jaqueline Almeida Pimentel

  • Mário Sérgio Fernandes

  • Hedi Gharsallah

  • Zied Hajjej

  • Walid Samoud

  • Oleg Grebenchikov

  • Valery Likhvantsev

  • Elena Stroiteleva

  • Nikolaos Markou

  • Dimitra Bakali

  • Dionysia Koutrafouri

  • Ahmed Subhy Alsheikhly

  • Sara Maccherani

  • Janneke Horn

  • Mohamed Elbahnasawy

  • Arezoo Ahmadi

  • Lien Decaesteker

  • Daphne Decruyenaere

  • Ruth Demeersseman

  • Yves Devriendt

  • Karen Embo

  • Ditty van Duijn

  • Patricia Ormskerk

  • Melanie Glasbergen-van Beijeren

  • Hassane Njimi

  • Alain Cariou

  • Christophe Lelubre

  • Giuseppe Ristagno

  • Nino Stocchetti

  • Mauro Oddo

  • Cathy De Deyne

  • Giuseppe Citerio

  • September 8, 2026

Share

  • 1

    Traumatic brain injury (TBI) is a leading cause of mortality among young adults, with over 50 million cases globally each year.

  • 2

    Approximately 50% of TBI patients experience anemia, defined as hemoglobin levels below 9 g/dL, which can worsen cerebral ischemia.

  • 3

    The TRAIN trial found that a liberal transfusion strategy (Hb <9 g/dL) significantly reduced unfavorable neurological outcomes compared to a restrictive strategy (Hb <7 g/dL).

  • 4

    The secondary analysis of the TRAIN trial focused on moderate to severe TBI patients and evaluated the impact of hemoglobin thresholds on neurological outcomes.

  • 5

    The primary outcome of the study was unfavorable neurological status at 180 days, assessed using the Glasgow Outcome Scale Extended (GOS-E).

Original Source(s)

Restrictive vs Liberal Transfusion Strategy in Traumatic Brain Injury: A Secondary Analysis of the TRAIN Trial

  • by Irene Sbaraini Zernini, Chiara Faso, Carla Bittencourt Rynkowski, Kirsten Moller, Piet Lormans, Manuel Quintana Diaz, Anselmo Caricato, Marjorie Beumier, Evy Voets, Mario Arias, Herve Quintard, Diego Morocho, Pedro Kurtz, Erik Roman Pognuz, Olivier Huet, Ata Mahmoodpoor, Aaron Blandino-Ortiz, Sara Alcantara, Russell Chabanne, Francisco Cicho, Stan Popugaev, Angelo Giacomucci, Jamil Dibu, Raphael Cinotti, Pierre Bouzat, Jean-Louis Vincent, Elisa Gouvêa Bogossian, Fabio Silvio Taccone, TRAIN Study Trial Group, Claudia Díaz, Andrés Saravia, Ahmas Bayrlee, Laura Nedolast, Hussam Elkambergy, Haamid Siddique, Jihad Mallat, Nahla AlJaberi, Samer Shoshan, Ayo Mandi, Bruno De Oliveira, Malligere Prasanna, Rehan Haque, Dnyaneshwar Munde, Sara Chaffee, Fatma Alawadhi, Eija Junttila, Teemu Luoto, Simona Šteblaj, Jacques Creteur, Dominique Durand, Caroline Abbenhuijs, Nancy Itesa Matumikina, Filippo Annoni, Leda Nobile, Miguel Ulloa Bersatti, Igor Yovenko, Alexander Tsarev, Jasperina Dubois, Luc Janssen, Luigi Zattera, Leire Pedrosa, Berta Monleon Lopez, Ainhoa Serrano, Nekane Romero-García, Xavier Wittebole, Antonio M Dell'Anna, Camilla Gelormini, Eleonora Stival, Pilar Marcos Neira, Regina Roig Pineda, Lara Bielsa Berrocal, Maite Misis del Campo, Stepani Bendel, Jorge H Mejía-Mantilla, Ángela Marulanda, Wojciech Dabrowski, Rune Damgaard Nielsen, Markus Harboe Olsen, Helene Ravnholt Jensen, Ida Møller Larsen, Roberta Tallarico, Umberto Lucangelo, Maria Isabel Gonzales Perez, Carole Ichai, Karim Asenhoune, Karim Lakhal, Charlotte Fernandez-Canal, Samuel Gay, Marie Lebouc, David Bougon, Etienne Escudier, Michel Sirodot, Albrice Levrat, Alix Courouau, Jacques Duranteau, Aurore Rodrigues, Naima Makouche, Gilles Francony, Olivier Vincent, Perrine Boucheix, Clotilde Schilte, Anais Adolle, Thomas Gargadennec, Patricia Dias, Gwenaelle Desanglois, Alexia Meheut, Pauline Cam, Geert Meyfroidt, Liese Mebis, Alexandra Hendrickx, Pieetr Wouters, Sylvia Van Hulle, Alain D'Hondt, Marc Burgeois, Olivier Simonet, Frederic Vallot, Pablo Centeno, Matias Anchorena, Ximena Benavente, Maximilian D'Onofrio, Nydia Funes, Antonio Barra de Oca, Gabriela Izzo, Charlotte Castelain, Filippo Soetens, Manuel Jabaja, Diego Tutillo, Celeste Dias, Elena Perez Solada, Pilar Justo, Amparo Lopez Gomez, Francisco Chico, Maria Fernanda Garcia, Fabricio Picoita, Stela Velasco Eichler, Gabriela Nonticuri Bianchi, João Pedro Britz, Jaqueline Almeida Pimentel, Mário Sérgio Fernandes, Hedi Gharsallah, Zied Hajjej, Walid Samoud, Oleg Grebenchikov, Valery Likhvantsev, Elena Stroiteleva, Nikolaos Markou, Dimitra Bakali, Dionysia Koutrafouri, Ahmed Subhy Alsheikhly, Sara Maccherani, Janneke Horn, Mohamed Elbahnasawy, Arezoo Ahmadi, Lien Decaesteker, Daphne Decruyenaere, Ruth Demeersseman, Yves Devriendt, Karen Embo, Ditty van Duijn, Patricia Ormskerk, Melanie Glasbergen-van Beijeren, Hassane Njimi, Alain Cariou, Christophe Lelubre, Giuseppe Ristagno, Nino Stocchetti, Mauro Oddo, Cathy De Deyne, Giuseppe Citerio

  • September 8, 2026

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