Transfusion Medicine Department, Hospital de Santa Maria, 218728Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221087219. doi: 10.1177/10760296221087219.
Acute upper or lower Gastrointestinal bleeding (GIB) is a clinical emergency in which transfusion can be lifesaving. An individualized and restrictive transfusion strategy is recommended. This study aims to analyze and evaluate GIB transfusion practices during one year in a large tertiary hospital in Lisbon, Portugal. All patients with GIB and transfusion support during 2014 were identified and clinical data collected and statistically treated. There were 1005 GIB transfusion episodes, in a total of 494 patients. Upper GIB was more common. The median haemoglobin concentration that triggered RBC transfusion was 7,6 g/dL with a median of 2 RBC per episode. In 21,9% of episodes, RBC were used in combination with other therapies, in 70,8%, only RBC were administered and in 7,3% RBC were not used at all. In the subgroup of patients receiving FC and/or PCC there were higher median of blood products transfused: RBC (3 17 units), FFP (3 units), PC (1 unit). In a large percentage of the transfusion episodes for GIB, only RBC were used whereas only 7,3% of the GIB didn't require RBC transfusion. Patients requiring FC and/or PCC, needed more allogenic components. We observed, in accordance with the latest clinical practice guidelines and the published literature, a restrictive transfusion approach in our clinical practice.
急性上或下胃肠道出血（GIB）是一种临床急症，输血可以救命。推荐采用个体化和限制性输血策略。本研究旨在分析和评估葡萄牙里斯本一家大型三级医院一年内的 GIB 输血实践。确定了 2014 年所有 GIB 伴输血支持的患者，并收集了临床数据并进行了统计学处理。共有 1005 例 GIB 输血发作，共涉及 494 名患者。上 GIB 更为常见。触发 RBC 输血的血红蛋白浓度中位数为 7.6 g/dL，每例平均输 2 个 RBC。在 21.9%的病例中，RBC 与其他疗法联合使用，在 70.8%的病例中，仅给予 RBC，在 7.3%的病例中，根本未使用 RBC。在接受 FC 和/或 PCC 的患者亚组中，输注的血液制品中位数更高：RBC（317 单位）、FFP（3 单位）、PC（1 单位）。在 GIB 输血的大部分病例中，仅使用 RBC，而只有 7.3%的 GIB 不需要 RBC 输血。需要 FC 和/或 PCC 的患者需要更多同种异体成分。我们观察到，与最新的临床实践指南和已发表的文献一致，我们的临床实践中采用了限制性输血方法。
