Transfusion strategy for acute upper gastrointestinal bleeding

Handel, James; Lang, Eddy

doi:10.1017/cem.2014.76

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Treatment of anemia in cirrhosis depends on the etiology. For symptomatic anemia related to variceal bleeding in cirrhosis transfusion is given for Hb less than 7 g/dL and maintaining the level between 7 and 9 g/dL has been shown to improve survival in Child-Pugh A and B cirrhosis as well as decrease rebleeding risk [42][43][44]. Iron replacement is also used to treat iron deficiency leading to anemia in cirrhosis.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Hematological Abnormalities in Cirrhosis: A Narrative Review

Lingas¹

2023

Cureus

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Liver cirrhosis remains a major public health issue. Liver fibrosis leading to cirrhosis is the terminal stage of various chronic liver diseases. Inflammatory cytokines are involved in the pathogenesis. Patients with cirrhosis often have hematological abnormalities, such as anemia and thrombocytopenia, which have multifactorial etiologies. Anemia in cirrhosis could be related to bleeding leading to iron deficiency anemia or other nutritional anemia such as vitamin B12 and folate deficiency. The pathophysiology of thrombocytopenia in liver cirrhosis has been postulated to range from splenic sequestration to bone marrow suppression from toxic agents, such as alcohol. It often complicates management due to the risk of bleeding with severely low platelets. This review aimed to highlight pathogenesis of liver cirrhosis, hematological abnormalities in liver cirrhosis, and their clinical significance.

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Section: Diagnosis and Treatmentmentioning

confidence: 99%

Hematological Abnormalities in Cirrhosis: A Narrative Review

Lingas¹

2023

Cureus

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“…, initiating transfusion at Hb level < 7 g/dL to maintain Hb between 7-9 g/dL. This has been found to have a survival benefit in patients with Child’s A and B cirrhosis and it also decreases the risk of rebleeding in all patients with cirrhosis[ 42 , 43 , 44 ]. Intravenous splanchnic vasoconstrictors (terlipressin, somatostatin, octreotide), antibiotic prophylaxis, and intravenous proton pump inhibitors are recommended in the initial management of all cases of acute variceal bleed[ 45 ].…”

Section: Management Of a Patient Of Anemia In Cirrhosis With Ongoing/acute Bleedingmentioning

confidence: 99%

Anemia in cirrhosis: An underestimated entity

Manrai¹,

Dawra²,

Kapoor³

et al. 2022

WJCC

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Anemia in a patient with cirrhosis is a clinically pertinent but often overlooked clinical entity. Relevant guidelines highlight the algorithmic approach of managing a patient of cirrhosis presenting with acute variceal hemorrhage but day-to-day management in hospital and out-patient raises multiple dilemmas: Whether anemia is a disease complication or a part of the disease spectrum? Should iron, folic acid, and vitamin B complex supplementation and nutritional advice, suffice in those who can perform tasks of daily living but have persistently low hemoglobin. How does one investigate and manage anemia due to multifactorial etiologies in the same patient: Acute or chronic blood loss because of portal hypertension and bone marrow aplasia secondary to hepatitis B or C viremia? To add to the clinician’s woes the prevalence of anemia increases with increasing disease severity. We thus aim to critically analyze the various pathophysiological mechanisms complicating anemia in a patient with cirrhosis with an emphasis on the diagnostic flowchart in such patients and proposed management protocols thereafter.

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“…Estima-se que a ocorrência de óbitos como resultado da utilização de um componente de sangue transfundido incorretamente é de 1:500.000 como consequência de reações imediatas 9 .…”

Section: Introductionunclassified

Fatores associados à gravidade das reações transfusionais ocorridas em hospital de ensino, na cidade de São Paulo, entre 2007-2019

et al. 2021

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Introdução: Reações transfusionais podem acarretar sérias consequências aos receptores de hemocomponentes. Objetivo: Analisar a proporção de reações adversas quanto ao grau de severidade observado nas transfusões de sangue e identificar os fatores associados à gravidade dos incidentes transfusionais imediatos. Método: Estudo longitudinal retrospectivo de avaliação epidemiológica das reações transfusionais imediatas ocorridas entre 2007-2019 em hospital de ensino. Resultados: Das 332.222 transfusões sanguíneas administradas, foram reportadas 1.448 notificações de reações transfusionais imediatas. A média de incidência de reação transfusional foi de 4,4 por mil/ano. As reações moderadas e graves representam 13,5% do total dos eventos. Hemoglobulina e hematócrito não apresentaram distribuição normal (p ≤ 0,001). Conclusões: A análise dos dados possibilitou avaliar a prática transfusional na instituição, que se mostrou adequada, refletindo os constantes esforços para retroalimentar o Sistema Nacional de Hemovigilância. A gravidade das reações está associada à unidade de internação, sendo mais frequentes as graves nas unidades críticas e semicríticas, porém o estudo demonstrou que não se deve negligenciar as reações leves.

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Transfusion strategy for acute upper gastrointestinal bleeding

Cited by 5 publications

References 13 publications

Hematological Abnormalities in Cirrhosis: A Narrative Review

Hematological Abnormalities in Cirrhosis: A Narrative Review

Anemia in cirrhosis: An underestimated entity

Fatores associados à gravidade das reações transfusionais ocorridas em hospital de ensino, na cidade de São Paulo, entre 2007-2019

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