Restrictive transfusion strategy safe for acute GI bleeding

Restrictive transfusion strategy safe for acute GI bleeding
For patients with severe acute gastrointestinal bleeding, a restrictive transfusion approach is safe and effective compared with a liberal approach, according to a study published in the Jan. 2 issue of the New England Journal of Medicine.

(HealthDay)—For patients with severe acute gastrointestinal bleeding, a restrictive transfusion approach is safe and effective compared with a liberal approach, according to a study published in the Jan. 2 issue of the New England Journal of Medicine.

Càndid Villanueva, M.D., from the Hospital de Sant Pau in Barcelona, Spain, and colleagues conducted a to compare the efficacy and safety of a restrictive transfusion strategy (461 patients; transfusion when hemoglobin level fell below 7 g/dL) with a liberal transfusion strategy (460 patients; transfusion when fell below 9 g/dL) for severe acute .

The researchers found that 51 percent in the restrictive-strategy group and 15 percent in the liberal-strategy group did not receive a transfusion (P < 0.001). In the restrictive-strategy group, the probability of survival at six weeks was significantly higher (95 versus 91 percent; hazard ratio for death with restrictive strategy, 0.55). Further bleeding and adverse events occurred in significantly fewer patients in the restrictive-strategy group versus the liberal-strategy group (10 versus 16 percent and 40 versus 48 percent, respectively). For patients who had bleeding associated with a peptic ulcer, the probability of survival was non-significantly increased in the restrictive-strategy group. For patients assigned to the liberal-strategy group, but not the restrictive-strategy, portal-pressure gradient increased significantly within the first five days.

"Our results suggest that, in patients with acute gastrointestinal bleeding, a strategy of not performing transfusion until the falls below 7 g per deciliter is a safe and effective approach," the authors write.

One author disclosed a financial tie to Sequana Medical.

More information: Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

AABB releases new guidelines for red blood cell transfusion

Mar 26, 2012

AABB (formerly known as the American Association of Blood Banks) recommends a restrictive red blood cell transfusion strategy for stable adults and children, according to new guidelines being published in Annals of Internal Me ...

Recommended for you

Trapping the Ebola virus in transit

51 minutes ago

The deadly Ebola virus makes use of host mechanisms – including a specific type of membrane-bound calcium channel – to gain entry into the cell cytoplasm. LMU researchers now show that blocking this channel ...

Saudi reports 10 MERS deaths in a week

57 minutes ago

Ten more people in Saudi Arabia have died from MERS over the past week, health ministry figures showed on Friday, after an international mission urged extra measures to combat the virus.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.