Transfusion strategy for acute upper gastrointestinal bleeding.
نویسندگان
چکیده
Clinical question Does a hemoglobin transfusion threshold of 70 g/L yield better patient outcomes than a threshold of 90 g/L in patients with acute upper gastrointestinal bleeding? Article chosen Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013;368(1):11-21. Study objectives The authors of this study measured mortality, from any cause, within the first 45 days, in patients with acute upper gastrointestinal bleeding, who were managed with a hemoglobin threshold for red cell transfusion of either 70 g/L or 90 g/L. The secondary outcome measures included rate of further bleeding and rate of adverse events.
منابع مشابه
Transfusion strategies for acute upper gastrointestinal bleeding.
BACKGROUND The hemoglobin threshold for transfusion of red cells in patients with acute gastrointestinal bleeding is controversial. We compared the efficacy and safety of a restrictive transfusion strategy with those of a liberal transfusion strategy. METHODS We enrolled 921 patients with severe acute upper gastrointestinal bleeding and randomly assigned 461 of them to a restrictive strategy ...
متن کاملBlood transfusion for upper gastrointestinal bleeding: is less more again?
BACKGROUND The hemoglobin threshold for transfusion of red blood cells in patients with acute gastrointestinal (GI) bleeding is controversial. We compared the efficacy and safety of a restrictive transfusion strategy with those of a liberal transfusion strategy. METHODS OBJECTIVE The objective was to prove that the restrictive threshold for red blood cell transfusion in patients with acute...
متن کاملACP Journal Club. A restrictive transfusion strategy reduced 45-day mortality in patients with acute upper GI bleeding.
Patients: 921 patients > 18 years of age (mean age 65 y, 68% men) who were hospitalized with severe, acute upper GI bleeding (hematemesis, bloody nasogastric aspirate, or melena). Exclusion criteria included massive exsanguinating or lower GI bleeding; recent trauma or surgery; Rockall score = 0 (low rebleeding risk) with hemoglobin (Hgb) level > 12 g/dL; or an acute coronary syndrome, symptoma...
متن کاملDischarge hemoglobin and outcome in patients with acute nonvariceal upper gastrointestinal bleeding
BACKGROUND AND STUDY AIMS Many patients with acute gastrointestinal bleeding present with anemia and frequently require red blood cell (RBC) transfusion. A restrictive transfusion strategy and a low hemoglobin (Hb) threshold for transfusion had been shown to produce acceptable outcomes in patients with acute upper gastrointestinal bleeding. However, most patients are discharged with mild anemia...
متن کاملUpdate on the transfusion in gastrointestinal bleeding (TRIGGER) trial: statistical analysis plan for a cluster-randomised feasibility trial
BACKGROUND Previous research has suggested an association between more liberal red blood cell (RBC) transfusion and greater risk of further bleeding and mortality following acute upper gastrointestinal bleeding (AUGIB). METHODS AND DESIGN The Transfusion in Gastrointestinal Bleeding (TRIGGER) trial is a pragmatic cluster-randomised feasibility trial which aims to evaluate the feasibility of i...
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ورودعنوان ژورنال:
- CJEM
دوره 17 5 شماره
صفحات -
تاریخ انتشار 2015