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Life-threatening Bleeding - 2018

Life-threatening bleeding can be defined in many aspects: by extent of blood loss, by the presence of clinical and laboratory signs of tissue hypoperfusion or signs of organ functions failure. Sometimes bleeding is not associated with major blood loss, but it threatens the life by localization of bleeding to the regions important for maintaining vital functions (eg. brain). In our algorithm we pursue bleeding from esophageal varices, which are frequent complication of hepatic cirrhosis. The goal of this algorithm is to show you the right steps and resolution of the therapy of life-threatening bleeding.  

Author: Olga Smékalová, MD, Michaela Brázdilová, Jan Sapák

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: Haemorrhage | esophagus varice veins | hypovolemia

Educational evel: Undergraduate level | Graduate

Life-threatening bleeding can be defined in many aspects: by extent of blood loss, by the presence of clinical and laboratory signs of tissue hypoperfusion or signs of organ functions failure. Sometimes bleeding is not associated with major blood loss, but it threatens the life by localization of bleeding to the regions important for maintaining vital functions (eg. brain). In our algorithm we pursue bleeding from esophageal varices, which are frequent complication of hepatic cirrhosis. The goal of this algorithm is to show you the right steps and resolution of the therapy of life-threatening bleeding.  


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Review

Bleeding from esophageal varices is life threatening and belongs to the most serious complications of portal hypertension. Interactive algorithm based on current guidelines leads investigators through prehospital and hospital management of treatment. Emphasis should be placed on ensuring vital functions, volume expansion and haemosubstitution, and correction of coagulopathy according to viscoelastic methods and, of course, to stop bleeding itself.

publikováno: 3.7.2018 | last modified on: 22.11.2018