Blood transfusion in acute upper gastrointestinal bleeding: is giving more blood always better?

Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency which results in significant morbidity and mortality worldwide. The incidence of UGIB ranges from 50 to 150 per 100,000 adults per year (1,2). UGIB leads to a decrease in circulatory blood volume, which in turn results in hypotension and reduced tissue perfusion. This can lead to unfavourable end organ damage such as myocardial infarction or kidney injury. Although there have been considerable advances in endoscopic intervention for the management of bleeding, 30-day mortality rates still range between 5–14% (3).