Red Blood Cell Transfusions and Iron Therapy for Patients Presenting with Acute Upper Gastrointestinal Bleeding: A Survey of Canadian Gastroenterologists and Hepatologists
Table 3
Clinicians deciding on the best next step in management of an actively bleeding patient with UGIB (see scenario below).
A 50-year-old healthy patient presents with hematemesis and is hemodynamically unstable (BP 90/50, HR 115) with evidence of a volume deficit on clinical exam. Two large bore IVs were inserted and resuscitation was initiated with intravenous crystalloid. Routine blood work including a CBC and RBC cross-match has been sent. What would be your next steps?
I would hold off on a blood transfusion until I know the hemoglobin level
38.6% (31.8%; 46.0%)
I would wait for cross-matched RBCs and transfuse 1-2 units once available
25.0% (19.2%; 31.9%)
It depends on how much the patient appears to be bleeding
18.2% (13.2%; 24.5%)
I would transfuse 1-2 units of uncross-matched red blood cells STAT
13.1% (8.9%; 18.6%)
It depends on patient’s symptoms
4.6% (2.3%; 8.7%)
I would wait for cross-matched RBCs and transfuse 3-4 units once available
