Restrictive transfusion strategy saves blood and is safe in most clinical settings, including gastrointestinal bleeding. However, generalizability of a restrictive transfusion approach in acute gastrointestinal bleeding remains controversial as it often affects elderly patients with major cardiovascular comorbidity who have been excluded from existing trials.
This is a preview of subscription content, log in via an institution to check access.
References
Carson, J. L., Carless, P. A. & Hebert, P. C. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD002042 http://dx.doi.org/10.1002/14651858.CD002042.pub3.
Herbert, P. C. et al. A multicenter, randomized, controlled trial of transfusion requirements in critical care. N. Engl. J. Med. 340, 409–417 (1999).
Villanueva, C. et al. Transfusion strategies for acute upper gastrointestinal bleeding. N. Engl. J. Med. 2013. 368, 11–21 (2013).
Jairath, V. et al. Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial. Lancet http://dx.doi.org/10.1016/S0140–6736(14)61999–1.
Jairath, V. et al. Red cell transfusion for the management of upper gastrointestinal haemorrhage. Cochrane Database of Systematics Reviews Issue 9. Art. No.: CD006613 http://dx.doi.org/10.1002/14651858.CD006613.pub3.
Middelburg, R. A., van de Watering, L. M. & van der Bom, J. G. Blood transfusions: good or bad? Confounding by indication, an underestimated problem in clinical transfusion research. Transfusion 50, 1181–1183 (2010).
McCormick, P. A., Jenkins, S. A., McIntyre, N. & Burroughs, A. K. Why portal hypertensive varices bleed and bleed: a hypothesis. Gut 36, 100–103 (1995).
Rohde, J. M. et al. Health care–associated infection after red blood cell transfusion: a systematic review and meta-analysis. JAMA 311, 1317–1326 (2014).
Koch, C. G. et al. Duration of red-cell storage and complications after cardiac surgery. N. Engl. J. Med. 358, 1229–1239 (2008).
Lacroix, J. et al. Age of transfused blood in critically ill adults. N. Engl. J. Med. 372, 1410–1418 (2015).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Villanueva, C. Blood transfusion for acute upper gastrointestinal bleeding. Nat Rev Gastroenterol Hepatol 12, 432–434 (2015). https://doi.org/10.1038/nrgastro.2015.116
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrgastro.2015.116
- Springer Nature Limited