Revisiting Triggers: Optimal Thresholds for Transfusion in Gastrointestinal Bleeding May Be Higher Than Restrictive Guidelines

Abstract

Acute upper gastrointestinal bleeding (AUGIB) is an acute medical emergency with an incidence of 48 to 180 cases and a case fatality of around 10%.1–4 Up to 50% of patients receive red blood cell (RBC) transfusion during resuscitation.4,5 Earlier guidelines recommended RBC transfusion when hemoglobin (Hb) fell lower than 10 g/dL, but following the results of clinical trials demonstrating the safety of more restrictive transfusion, clinical practice has shifted to a more conservative approach to transfusion for AUGIB,6–9 offering the potential to preserve global blood resources.