Is upper gastrointestinal bleeding a blood transfusion? The guide summarizes these 4 points

Acute upper gastrointestinal bleeding is one of the common acute and critical diseases in the emergency department, with an annual incidence of 100/100,000~180,000/100,000 in adults [1], and a case fatality rate of 2%~15% [2].

Standardizing the diagnosis and treatment process is of great
significance to improve the prognosis.

When upper gastrointestinal bleeding is indicated, do you need to be treated urgently with blood transfusion? See what the guide says!

When do platelet transfusions be required?

Platelet transfusions should be given in the following cases:

• systolic blood pressure< 90 mmHg;

• Heart rate> 110 beats/min;

• Hemoglobin (Hb) <70g/L;

• hematocrit (Hct) < 25% or hemorrhagic shock; Active bleeding with a platelet count of <50×10 9/L platelet<b10>
  transfusion should be given.
  

What else should I pay attention to for blood transfusion?

Weigh the risks and benefits of transfusion and adopt the optimal transfusion strategy
.

Pre-set blood products (1:1:1 ratio of red blood cells, plasma and platelets).

The Hb target is 70-90 g/L, and variceal bleeding is limited to 70 g</L
except for liver function Child-Pugh class C.

Advanced age, underlying cardiovascular and cerebrovascular disease (eg, acute coronary syndrome, stroke, or transient ischemic attack), hemodynamic instability, or persistent massive bleeding, control of Hb<90g/L or above<b10>.

For patients with active bleeding, if the prothrombin time (or international normalized ratio) or activated partial thromboplastin time is greater than 1.
5 times normal, fresh frozen plasma (FFP) should be transfused, and if the fibrinogen (FIB) level is still less than 1.
5 g/L after FFP, FIB infusion or cryoprecipitate
is recommended.

In cirrhosis of the liver, active variceal bleeding, if the FIB < 1 g/L, FFP<b10> should be infused.

Empiric use of calcium (eg, 1 g of calcium chloride after transfusion of 4 blood products) to monitor calcium ion levels
.

Acute upper gastrointestinal bleeding, what are the treatment drugs?

Acute upper gastrointestinal bleeding, what should I be monitored for?

What clinical signs and symptoms are prioritized for diagnosing a disease?

Open the "Decision Assistant App" clinical guideline module

Search for the name of the disease you want to know and talk to authoritative guides at home and abroad! 👇

Authoritative guide at home and abroad

The Decision Assistant "Clinical Guidelines" module is available 👇