Effect of early blood transfusion on gastrointestinal haemorrhage

Br J Surg. 1986 Oct;73(10):783-5. doi: 10.1002/bjs.1800731007.


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 24 h 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 less than 0.01, chi 2 with Yates' correction). Early blood transfusion appears to reverse the hypercoagulable response to haemorrhage thereby encouraging re-bleeding and hence the need for an operation.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Coagulation Disorders / etiology*
  • Blood Coagulation Tests / methods
  • Clinical Trials as Topic
  • Female
  • Gastrointestinal Hemorrhage / therapy*
  • Humans
  • Male
  • Pilot Projects
  • Prospective Studies
  • Random Allocation
  • Transfusion Reaction*