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Am Fam Physician. 2021 Jan 15;103(2):70.

Updated recommendation. The article “Upper Gastrointestinal Bleeding in Adults: Evaluation and Management,” (March 1, 2020, p. 294) referenced a recommendation from 2010 regarding blood transfusions for patients with upper gastrointestinal (GI) bleeding when hemoglobin is less than 7 g per dL (70 g per L). During the publication process of this manuscript the recommendations were updated in December 2019, but these updates were not included in the article. The seventh sentence of the abstract (page 294) should have read: “A bolus of normal saline or lactated Ringer solution should be rapidly infused to correct hypovolemia and to maintain blood pressure, and blood should be transfused when hemoglobin is less than 8 g per dL.” The first sentence of the “Transfusions and Coagulopathy” section should have read: “Current guidelines recommend blood transfusion for patients with upper GI bleeding when hemoglobin is less than 8 g per dL (80 g per L), including patients with coronary artery disease, recent cardiac surgery, or hematologic malignancies.27” This update also required a change to question 6 from the March 1, 2020, CME Quiz (page 268). The question should have read: “A patient with upper GI bleeding from peptic ulcer disease is transferred to the hospital because he is hemodynamically unstable. Except for anticoagulation for deep venous thrombosis, he has no significant medical history. The patient's international normalized ratio is 1.5 and his hemoglobin is 9 g per dL (90 g per L). Which one of the following recommendations is correct?” The correct answer choice is C as the answer choices were not affected.

Also, in the sixth sentence of the abstract and the first sentence of the second paragraph of the “Initial Evaluation and Stabilization” section, the laboratory test type and crossmatch was listed instead of type and screen. In both places, the sentence should have read: “Laboratory tests should include a complete blood count, basic metabolic panel, coagulation panel, liver tests, and type and screen.” The online version of this article and the March 1, 2020 CME Quiz have been corrected.

 

 

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