GI Bleeding: The Evidence Behind When to Transfuse?
When patients present to the Emergency Department with acute upper GI bleeding, the natural inclination is to quickly pull the transfusion trigger. However, a 2013 study gives us pause:
Study Design: Randomized control trial that compared a restrictive transfusion strategy (Hemoglobin: 7 g/dL) to a liberal transfusion strategy (Hemoglobin: 9 g/dL).
Results: A transfusion trigger at a hemoglobin of 7g/dL may be safe in non-exsanguinating, GI bleeders, as the results showed better outcomes for those receiving the restrictive strategy.
Existing literature has demonstrated that a higher threshold for transfusion is beneficial in many populations (i.e., sepsis). This article adds to that literature when a patient with severe GI bleeding is not massively exsanguinating.