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In 2013, Dr. Villanueva et al. randomly assigned over 921 patients with upper gastrointestinal bleed who presented with either hematemesis or melena to either low transfusion goal of >7 threshold or greater transfusion goal of >9 threshold.

Their goal was to assess all-cause mortality in these patients. Patients who received restrictive transfusion showed an almost double reduction in terms of primary outcome (P=0.02) as compared with the liberal group. It’s worthwhile to look at TRISS trial results here that studied the transfusion thresholds in patients with septic shock and found no difference in terms of mortality.

The authors concluded a restrictive strategy significantly improved outcomes in patients with acute upper gastrointestinal bleeding.

Source: NEJM

Transfusion Strategies for Acute Upper Gastrointestinal Bleeding Trial (2013)