Gastroesophageal Variceal Bleeding Management

Zanetto, Alberto; García–Tsao, Guadalupe

doi:10.1007/978-3-030-24490-3_4

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Intravenous Splanchnic Vasoconstrictors1

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2021

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“…In clinical practice, the choice among these three intravenous vasoconstrictors is dictated by local availability and cost [40]. Recommended dose for terlipressin of 2 mg/4 h during the first 48 h, followed by 1 mg/4 h. If terlipressin is contraindicated, somatostatin is an alternative and should be administered as a continuous infusion of 250 mg/h (that can be increased up to 500 mg/h), with an initial bolus of 250 mg.…”

Section: Intravenous Splanchnic Vasoconstrictorsmentioning

confidence: 99%

Recent Advances in the Management of Acute Variceal Hemorrhage

Zanetto

Shalaby

Feltracco

et al. 2021

JCM

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Gastrointestinal bleeding is one of the most relevant causes of death in patients with cirrhosis and clinically significant portal hypertension, with gastroesophageal varices being the most frequent source of hemorrhage. Despite survival has improved thanks to the standardization on medical treatment aiming to decrease portal hypertension and prevent infections, mortality remains significant. In this review, our goal is to discuss the most recent advances in the management of esophageal variceal hemorrhage in cirrhosis with specific attention to the treatment algorithms involving the use of indirect measurement of portal pressure (HVPG) and transjugular intrahepatic portosystemic shunt (TIPS), which aim to further reduce mortality in high-risk patients after acute variceal hemorrhage and in the setting of secondary prophylaxis.

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Section: Intravenous Splanchnic Vasoconstrictorsmentioning

confidence: 99%