Q: How the "massive" upper or lower gastrointestinal (UGI/LGI) bleed is defined?
Answer: Unlike hemoptysis, it is hard to quantify the GI bleed. UGI or LGI bleed is considered 'massive' if requires transfusion of 4 units of blood or more in 24 hours period. Other definitions described are hemodynamic instability with systolic blood pressure (SBP) less than 90 mmHg, and the initial decrease in hematocrit of 6 g/dL or less.
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2. Zuccaro G Jr. Management of the adult patient with acute lower gastrointestinal bleeding. American College of Gastroenterology. Practice Parameters Committee. Am J Gastroenterol 1998; 93:1202.