AIM: To compare the outcome of upper gastrointestinal bleeding (UGIB) between patients receiving restrictive and liberal transfusion. METHODS: PubMed, EMBASE, and Cochrane Library databases were employed to identify all relevant randomized controlled trials regarding the outcome of UGIB after restrictive or liberal transfusion. Primary outcomes were death and rebleeding. Secondary outcomes were length of hospitalization, amount of blood transfused, and hematocrit and hemoglobin at discharge or after expansion. RESULTS: Overall, 4 papers were included in this meta-analysis. The incidence of death was significantly lower in patients receiving restrictive transfusion than those receiving liberal transfusion (OR: 0.52, 95%CI: 0.31-0.87, P = 0.01). The incidence of rebleeding was lower in patients receiving restrictive transfusion than those receiving liberal transfusion, but this difference did not reach any statistical significance (OR: 0.26, 95%CI: 0.03-2.10, P = 0.21). Compared with those receiving liberal transfusion, patients receiving restrictive transfusion had a significantly shorter length of hospitalization (standard mean difference: -0.17, 95%CI: -0.30--0.04, P = 0.009) and a significantly smaller amount of blood transfused (standard mean difference: -0.74, 95%CI: -1.15--0.32, P = 0.0005) with a lower hematocrit and hemoglobin level at discharge or after expansion. CONCLUSION: Restrictive transfusion should be employed in patients with UGIB.
AIM: To compare the outcome of upper gastrointestinal bleeding (UGIB) between patients receiving restrictive and liberal transfusion. METHODS: PubMed, EMBASE, and Cochrane Library databases were employed to identify all relevant randomized controlled trials regarding the outcome of UGIB after restrictive or liberal transfusion. Primary outcomes were death and rebleeding. Secondary outcomes were length of hospitalization, amount of blood transfused, and hematocrit and hemoglobin at discharge or after expansion. RESULTS: Overall, 4 papers were included in this meta-analysis. The incidence of death was significantly lower in patients receiving restrictive transfusion than those receiving liberal transfusion (OR: 0.52, 95%CI: 0.31-0.87, P = 0.01). The incidence of rebleeding was lower in patients receiving restrictive transfusion than those receiving liberal transfusion, but this difference did not reach any statistical significance (OR: 0.26, 95%CI: 0.03-2.10, P = 0.21). Compared with those receiving liberal transfusion, patients receiving restrictive transfusion had a significantly shorter length of hospitalization (standard mean difference: -0.17, 95%CI: -0.30--0.04, P = 0.009) and a significantly smaller amount of blood transfused (standard mean difference: -0.74, 95%CI: -1.15--0.32, P = 0.0005) with a lower hematocrit and hemoglobin level at discharge or after expansion. CONCLUSION: Restrictive transfusion should be employed in patients with UGIB.
Authors: James D Lewis; Warren B Bilker; Colleen Brensinger; John T Farrar; Brian L Strom Journal: Am J Gastroenterol Date: 2002-10 Impact factor: 10.864
Authors: Alan N Barkun; Marc Bardou; Ernst J Kuipers; Joseph Sung; Richard H Hunt; Myriam Martel; Paul Sinclair Journal: Ann Intern Med Date: 2010-01-19 Impact factor: 25.391
Authors: R Phillip Dellinger; Mitchell M Levy; Jean M Carlet; Julian Bion; Margaret M Parker; Roman Jaeschke; Konrad Reinhart; Derek C Angus; Christian Brun-Buisson; Richard Beale; Thierry Calandra; Jean-Francois Dhainaut; Herwig Gerlach; Maurene Harvey; John J Marini; John Marshall; Marco Ranieri; Graham Ramsay; Jonathan Sevransky; B Taylor Thompson; Sean Townsend; Jeffrey S Vender; Janice L Zimmerman; Jean-Louis Vincent Journal: Crit Care Med Date: 2008-01 Impact factor: 7.598
Authors: Càndid Villanueva; Alan Colomo; Alba Bosch; Mar Concepción; Virginia Hernandez-Gea; Carles Aracil; Isabel Graupera; María Poca; Cristina Alvarez-Urturi; Jordi Gordillo; Carlos Guarner-Argente; Miquel Santaló; Eduardo Muñiz; Carlos Guarner Journal: N Engl J Med Date: 2013-01-03 Impact factor: 91.245
Authors: Joseph J Y Sung; Kelvin K F Tsoi; Terry K W Ma; Man-Yee Yung; James Y W Lau; Philip W Y Chiu Journal: Am J Gastroenterol Date: 2009-09-15 Impact factor: 10.864
Authors: Jacques Lacroix; Paul C Hébert; James S Hutchison; Heather A Hume; Marisa Tucci; Thierry Ducruet; France Gauvin; Jean-Paul Collet; Baruch J Toledano; Pierre Robillard; Ari Joffe; Dominique Biarent; Kathleen Meert; Mark J Peters Journal: N Engl J Med Date: 2007-04-19 Impact factor: 91.245
Authors: Tyler J Loftus; Kristina L Go; Steven J Hughes; Chasen A Croft; Robert Stephen Smith; Philip A Efron; Frederick A Moore; Scott C Brakenridge; Alicia M Mohr; Janeen R Jordan Journal: J Trauma Acute Care Surg Date: 2017-07 Impact factor: 3.313
Authors: Yuhree Kim; Gaya Spolverato; Donald J Lucas; Aslam Ejaz; Li Xu; Doris Wagner; Steven M Frank; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2015-08-26 Impact factor: 3.452
Authors: Rasmus Fabricius; Peter Svenningsen; Jens Hillingsø; Lars Bo Svendsen; Martin Sillesen Journal: World J Surg Date: 2016-05 Impact factor: 3.352
Authors: Kevin M Trentino; Shannon L Farmer; Michael F Leahy; Frank M Sanfilippo; James P Isbister; Rhonda Mayberry; Axel Hofmann; Aryeh Shander; Craig French; Kevin Murray Journal: BMC Med Date: 2020-06-24 Impact factor: 8.775
Authors: Klaus Görlinger; Antonio Pérez-Ferrer; Daniel Dirkmann; Fuat Saner; Marc Maegele; Ángel Augusto Pérez Calatayud; Tae-Yop Kim Journal: Korean J Anesthesiol Date: 2019-05-17
Authors: Jae Min Lee; Eun Sun Kim; Hoon Jai Chun; Young-Jae Hwang; Jae Hyung Lee; Seung Hun Kang; In Kyung Yoo; Seung Han Kim; Hyuk Soon Choi; Bora Keum; Yeon Seok Seo; Yoon Tae Jeen; Hong Sik Lee; Soon Ho Um; Chang Duck Kim Journal: Endosc Int Open Date: 2016-07-21