ICU SAQs · GI & nutrition / surgical
Acute variceal haemorrhage in a cirrhotic — resuscitation and the bundle
A CICM SAQ on the acute variceal bleed — the resuscitation (the intubate the encephalopathic, the restrictive transfusion), the variceal bundle (the terlipressin, the ceftriaxone, the band ligation), and the TIPS for the failure.
On this page
Study tools
Target exams
CICMFFICMEDIC
Prompt
A 55-year-old with the alcoholic cirrhosis presents with the massive haematemesis and the confusion. The BP is 90/60, the HR 110. Outline the immediate management.
Question
A 55-year-old with alcoholic cirrhosis presents with massive haematemesis and confusion. BP 90/60, HR 110. Outline the immediate management.
References5ShowHide
- [1]Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding N Engl J Med, 2013.PMID 23281973
- [3]Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage Lancet, 2000.PMID 11073021
- [7]Nicoara-Farcau O, Han G, Rudler M, et al. Effects of Early Placement of Transjugular Portosystemic Shunts in Patients With High-Risk Acute Variceal Bleeding: a Meta-analysis of Individual Patient Data Gastroenterology, 2021.PMID 32980344
- [8]Gralnek IM, Camus Duboc M, Garcia-Pagan JC, et al. Endoscopic diagnosis and management of esophagogastric variceal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline Endoscopy, 2022.PMID 36174643
- [9]Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, et al. Meta-analysis: antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding - an updated Cochrane review Aliment Pharmacol Ther, 2011.PMID 21707680