¿Estrategia restrictiva o liberal? | 21 ENE 13

Estrategias transfusionales para la hemorragia digestiva alta aguda

Evaluaron si un umbral restrictivo para la transfusión en pacientes con hemorragia digestiva aguda fue más seguro y eficaz que la estrategia transfusional liberal basada sobre el umbral aconsejado en las recomendaciones actuales.
Autor/a: Dres. Villanueva C, Colomo, Bosch A, Concepción M, N Engl J Med 2013;368:11-21
INDICE:  1. Artículo | 2. Artículo
Artículo

Referencias
1. Gralnek IM, Barkun AN, Bardou M. Management of acute bleeding from a peptic ulcer. N Engl J Med 2008; 359:928-37.
2. Barkun A, Bardou M, Marshall JK. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal  bleeding. Ann Intern Med 2003; 139:843-57.
3. Barkun AN, Bardou M, Kuipers EJ, et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 2010; 152:101-13.
4. Hébert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999; 340:409-17. [Erratum, N Engl J Med 1999;340:1056.]
5. Lacroix J, Hébert PC, Hutchison JS, et al. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med 2007; 356:1609-19.
6. Malone DL, Dunne J, Tracy JK, Putnam AT, Scalea TM, Napolitano LM. Blood transfusion, independent of shock severity, is associated with worse outcome in trauma. J Trauma 2003; 54:898-905.
7. Robinson WP III, Ahn J, Stiffler A, et al. Blood transfusion is an independent predictor of increased mortality in non-operatively managed blunt hepatic and splenic injuries. J Trauma 2005; 58:437-44.
8. Blair SD, Janvrin SB, McCollum CN, Greenhalgh RM. Effect of early blood transfusion on gastrointestinal haemorrhage. Br J Surg 1986; 73:783-5.
9. Villarejo F, Rizzolo M, Lopéz E, Domeniconi G, Arto G, Apezteguia C. Acute anemia in high digestive hemorrhage: comes following early red blood cell transfusion in acute upper gastrointestinal bleeding. Aliment Pharmacol Ther 2010; 32:215-24.
11. Halland M, Young M, Fitzgerald MN, Inder K, Duggan JM, Duggan A. Characteristics and outcomes of upper gastrointestinal hemorrhage in a tertiary referral hospital. Dig Dis Sci 2010; 55:3430-5.
12. Kravetz D, Sikuler E, Groszmann RJ. Splanchnic and systemic hemodynamics in portal hypertensive rats during hemorrhage and blood volume restitution. Gastroenterology 1986; 90:1232-40.
13. McCormick PA, Jenkins SA, McIntyre N, Burroughs AK. Why portal hypertensive varices bleed and bleed: a hypothesis. Gut 1995; 36:100-3.
14. Castañeda B, Morales J, Lionetti R, et al. Effects of blood volume restitution following a portal hypertensive–related bleeding in anesthetized cirrhotic rats. Hepatology 2001; 33:821-5.
15. British Society of Gastroenterology Endoscopy  Committee. Non-variceal upper gastrointestinal haemorrhage: guidelines. Gut 2002; 51:Suppl 4:iv1-iv6.
16. de Franchis R. Updating consensus in portal hypertension: report of the Baveno III  consensus workshop on definitions, methodology and therapeutic strategies in portal hypertension. J Hepatol 2000; 33: 846-52.
17. Villanueva C, Ortiz J, Miñana J, et al. Somatostatin treatment and risk stratification by continuous portal pressure monitoring during acute variceal bleeding. Gastroenterology 2001; 121:110-7.
18. Jairath V, Hearnshaw S, Brunskill SJ, et al Red cell transfusion for the manage -ment of upper gastrointestinal haemorrhage. Cochrane Database Syst Rev 2010; 9:CD006613.
19.  Carson JL, Terrin ML, Noveck H, et al. Liberal or restrictive transfusion in high- risk patients after hip surgery. N Engl J Med 2011; 365:2453-62.
20. Marik PE, Corwin HL. Efficacy of red cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med 2008; 36:2667-74.
21. de Franchis R. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol 2010; 53:762-8.
22. Crooks C, Card TIM, West J. Reductions in 28-day mortality following hospital admission for upper gastrointestinal hemorrhage. Gastroenterology 2011; 141: 62-70.
23. British Society of Gastroenterology. UK upper GI bleeding audit (http://www .bsg.org.uk/clinical/general/uk-upper-gi-bleeding-audit.html).
24. Roberts I, Evans P, Bunn F, Kwan I, Crowhurst E. Is the normalisation of blood pressure in bleeding trauma patients harmful? Lancet 2001; 357:385-7.
25. Duggan JM. Transfusion in gastrointestinal haemorrhage — if, when and how much? Aliment Pharmacol Ther 2001; 15: 1109-13.
26. Vamvakas EC, Blajchman MA. Transfusion-related  immunomodulation (TRIM): an update. Blood Rev 2007; 21: 327-48.
27. Koch CG, Li L, Sessler DI, et al. Duration of red-cell storage and complications after cardiac surgery. N Engl J Med 2008;  358:1229-39.
28. Kanias T, Gladwin MT. Nitric oxide, hemolysis, and the red blood cell storage lesion: interactions between transfusion, donor, and recipient. Transfusion 2012; 52:1388-92

 

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