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British Journal of Surgery
Volume 73, Issue 10, Pages 783 - 785
Published Online: 7 Dec 2005 Copyright © 1986 British Journal of Surgery Society Ltd.


Effect of early blood transfusion on gastrointestinal haemorrhage

Mr S. D. Blair, S. B. Janvrin, C. N. McCollum, R. M. Greenhalgh

Department of Surgery, Charing Cross and Westminster Medical School, London
Department of Surgery, Crawley Hospital, Crawley, Sussex, UK

Keywords: Gastrointestinal haemorrhage • blood transfusion • hypercoagulation

The effect of citrated stored blood on coagulation was studied initially in a pilot study where 25 patients with acute severe gastrointestinal haemorrhage had their whole blood coagulation measured using the Biobridge Impedance Clotting Time (ICT). This demonstrated that there is a hypercoagulable response to haemorrhage which was partially reversed by blood transfusion. Similar changes were noted in Kaolin Cephalin Clotting Times (KCCT). A further 50 patients were then randomized to receive, during the 24h after admission, either at least 2 units of blood or no blood transfusion unless the haemoglobin fell below 8 g/dl or they were shocked. In the transfused group nine patients re-bled compared with only one in the non-transfused group (P < 0·01, ² with Yates' correction). Early blood transfusion appears to reverse the hypercoagulable response to haemorrhage thereby encouraging rebleeding and hence the need for an operation.