Does a Restrictive Blood Transfusion Strategy Improve Outcomes in Lower Gastrointestinal Bleeding?

In upper gastrointestinal bleeding (UGIB), a restrictive red blood cell (RBC) transfusion policy with a hemoglobin (Hb) threshold <7.0 g/dL has been widely adopted. Although the greatest benefit is shown in patients with variceal bleeding, this approach has also been adopted for nonvariceal upper GI bleeding and more recently for lower GI bleeding (LGIB). However, data on outcomes of restrictive RBC transfusion in LGIB are sparse.

In a secondary analysis of prospective observational study data from 140 U.K. hospitals, investigators compared clinical outcomes of restrictive (Hb <80 g/L) versus liberal (Hb ≥80 g/L) RBC transfusion approaches in approximately 670 patients with LGIB. On univariate analysis, a liberal strategy was not associated …