ABSTRACT
G astro in testinal bleeding as a clinical en tity accounts for a significant p ro p o r tion o f all red b lood cell transfusions an d such patien ts require a p ro m p t response in com p o n en t availability from the B lood bank. A lthough acute spontaneous gas tro in testinal bleeding has som e sim ilarities to transfusion problem s seen in p a tients w ith massive trau m a (C hapter 14), patients w ith trau m a undergoing m as sive transfusion are usually hem ostatically no rm al p rio r to the onset o f the traum a, and hence, m anagem ent w ith crystalloids an d red cells m ay suffice un til a large loss o f intravascular volum e has occurred . In contrast, patien ts w ith acute gas tro in testinal bleeding often have an associated underly ing coagulopathy at the tim e o f p resentation , and this m ay require early trea tm en t w ith plasm a o r p late lets in add ition to any red cells transfused. F u rtherm ore, som e o f these patien ts m ay have been previously transfused, and alloantibodies to red cells m ay be present. This m ay cause an unacceptable delay in m aking phenotypically m atched red cells available resulting in the bypassing o f norm al procedures w ith associated increased risk.
