Transfusion in Gastrointestinal Bleeding

摘要: Acute upper gastrointestinal bleeding (AUGIB) is a common medical emergency which can present with life-threatening the single leading indication for transfusion of red blood cells in UK. AUGIB condition associated increasing age and comorbidity liver cirrhosis. Variceal patients cirrhosis presents particular challenge due to multifactorial underlying derangements coagulation, as well risks exacerbation portal hypertensive through injudicious volume replacement. A high-quality trial has demonstrated that restrictive approach cell (transfusion threshold 7 g/dL) leads reduction mortality rebleeding, compared liberal strategy 9 g/dL). However, this treatment effect was only significant cirrhosis, results cannot be generalised cardiovascular comorbidities. Although consensus guidelines recommend platelet transfusions actively count <50 × 109, there no evidence base these recommendations, routinely advocated until further evidence. Similarly little guide plasma transfusion, harms intervention must considered prior transfusion. The presence coagulopathy an increased risk mortality, but it unclear if simply biomarker illness rather than correction. Trials antifibrinolytics have been shown reduce after AUGIB, many studies were conducted before advent modern day endoscopy, raising uncertainty their effectiveness. Massive protocols should used caution overload elderly patients. important cause morbidity worldwide major user group all components, therefore research justified improve