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Transfusion Target Upper GI Bleeding — FRCA Final MCQ

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ModerateIntensive Care MedicineTransfusion Target Upper GI BleedingFRCA Final

A 55-year-old man (ASA III) in ICU develops acute upper GI bleeding with a Glasgow-Blatchford score of 12. He is haemodynamically unstable. According to NICE NG141, the target haemoglobin for transfusion in acute upper GI bleeding is:

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Correct answer: B — 70 g/L

NICE NG141 recommends a restrictive transfusion strategy in acute upper GI bleeding, targeting Hb >70 g/L (unless the patient has acute coronary syndrome, where 80-100 g/L may be appropriate). The Villanueva trial (2013) demonstrated that restrictive transfusion (Hb target 70) was associated with improved survival compared to liberal transfusion (Hb target 90) in upper GI bleeding, partly because over-transfusion increases portal pressure and rebleeding risk in variceal bleeding.

Reference: NICE – 2020 – NG141 Acute upper GI bleeding; Villanueva C et al – 2013 – NEJM