Restrictive vs Liberal Blood Transfusion for Acute Upper Gastrointestinal Bleeding: Rationale and Protocol for a Cluster Randomized Feasibility Trial

Vipul Jairath*, Brennan C. Kahan, Alasdair Gray, Caroline J. Dore, Ana Mora, Claire Dyer, Elizabeth A. Stokes, Charlotte Llewelyn, Adam A. Bailey, Helen Dallal, Simon M. Everett, Martin W. James, Adrian J. Stanley, Nicholas Church, Melanie Darvvent, John Greenaway, Ivan Le Jeune, Ian Reckless, Helen E. Campbell, Sarah MeredithKelvin R. Palmer, Richard F. A. Logan, Simon P. L. Travis, Timothy S. Walsh, Michael F. Murphy

*Corresponding author for this work

Research output: Contribution to journalLiterature reviewpeer-review

Abstract

Acute upper gastrointestinal bleeding (AUGIB) is the commonest reason for hospitalization with hemorrhage in the UK and the leading indication for transfusion of red blood cells (RBCs). Observational studies suggest an association between more liberal RBC transfusion and adverse patient outcomes, and a recent randomised trial reported increased further bleeding and mortality with a liberal transfusion policy. TRIGGER (Transfusion in Gastrointestinal Bleeding) is a pragmatic, cluster randomized trial which aims to evaluate the feasibility and safety of implementing a restrictive versus liberal RBC transfusion policy in adult patients admitted with AUGIB. The trial will take place in 6 UK hospitals, and each centre will be randomly allocated to a transfusion policy. Clinicians throughout each hospital will manage all eligible patients according to the transfusion policy for the 6-month trial recruitment period. In the restrictive centers, patients become eligible for RBC transfusion when their hemoglobin is

Original languageEnglish
Pages (from-to)146-153
Number of pages8
JournalTransfusion medicine reviews
Volume27
Issue number3
DOIs
Publication statusPublished - Jul 2013

Keywords

  • CRITICALLY-ILL PATIENTS
  • RED-CELL TRANSFUSION
  • HEALTH RESEARCH
  • CLINICAL-OUTCOMES
  • CARDIAC-SURGERY
  • HEMORRHAGE
  • REQUIREMENTS
  • MANAGEMENT
  • THRESHOLD
  • MORTALITY

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