scholarly journals Infusion-transfusion therapy in the treatment of patients with acute bleedings from the upper gastrointestinal tract

2012 ◽  
Vol 93 (2) ◽  
pp. 390-394
Author(s):  
G R Khalikova ◽  
I S Malkov ◽  
V V Fattakhov ◽  
M N Nasrullaev
Keyword(s):  
Gastrointestinal Tract ◽  
Blood Loss ◽  
Fresh Frozen Plasma ◽  
Endoscopic Hemostasis ◽  
Upper Gastrointestinal Tract ◽  
Infusion Therapy ◽  
Transfusion Therapy ◽  
Fresh Frozen ◽  
Upper Gastrointestinal ◽  
Frozen Plasma

Aim. To improve the treatment outcomes of patients with acute bleedings from the upper gastrointestinal tract by improving methods of endoscopic hemostasis and prediction of disease recurrence. Methods. The results of treatment of 776 patients with bleedings from the upper gastrointestinal tract have been analyzed. Methods of conservative therapy, endoscopic hemostasis and surgical treatment were used in combination with infusion therapy. Results. Established was the necessity of a differentiated method of endoscopic hemostasis, depending on the localization of the bleeding source, its intensity and effectiveness during ongoing bleedings. Infusion therapy should be initiated from the moment of verification of the diagnosis of acute bleeding from the upper gastrointestinal tract, regardless of the degree of blood loss, and already in the hospital’s emergency department. In cases of mild bleedings the infusion volume is 800-1000 ml: 80% crystalloids + 20% of colloids. The volume of infusion in moderate blood loss is 1500-2300 ml: 60% crystalloids + 20 colloids % + 20% fresh frozen plasma. The volume of infusion in severe blood loss is 2700 ml and more: 20% of crystalloids + 30% colloids + 30% fresh frozen plasma + 20% erythrocyte mass. Replacement therapy requires careful monitoring of the hemodynamic parameters and infusion load due to the unpredictability of body reactions to blood loss and its replacement. In the absence of an effect of conservative treatment within 6-24 hours an emergency operation is indicated with the choice of an optimal method based on an assessment of the physiological status on a POSSUM scale of assessment. Conclusion. Implementation of substitution therapy, which correlates to the degree of blood loss, critically important in order to eliminate ischemia of the wall of the gastrointestinal tract and prevent recurrence of bleeding; the usage of new approaches to the prediction of recurrent bleedings and improvement of methods of endoscopic haemostasis reduces the frequency of their occurrence, duration of in-hospital stay of patients and postoperative mortality.

The bleeding patient

2020 ◽  
pp. 403-428
Author(s):  
Anne Craig ◽  
Anthea Hatfield
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Disseminated Intravascular Coagulation ◽  
Oxygen Supply ◽  
Fresh Frozen Plasma ◽  
Blood Transfusions ◽  
Massive Blood Transfusion ◽  
Intravascular Coagulation ◽  
Fresh Frozen ◽  
Frozen Plasma

Part one of this chapter tells you about the physiology of blood and oxygen supply, about anaemia and tissue hypoxia, and the physiology of coagulation. Drugs that interfere with clotting are discussed. Bleeding, coagulation, and platelet disorders are covered as well as disseminated intravascular coagulation. Part two is concerned with bleeding in the recovery room: how to cope with rapid blood loss, managing ongoing blood loss, and how to use clotting profiles to guide treatment. There is also a section covering blood transfusion, blood groups and typing. Massive blood transfusion is clearly described, there are guidelines about when to use fresh frozen plasma, when to use platelets, and when to use cryoprecipitate. The final section of the chapter is about problems with blood transfusions.

scholarly journals Red blood cell transfusion is associated with further bleeding and fresh-frozen plasma with mortality in nonvariceal upper gastrointestinal bleeding

Transfusion ◽  
2015 ◽  
Vol 56 (4) ◽  
pp. 816-826 ◽  
Author(s):  
Kavitha Subramaniam ◽  
Katrina Spilsbury ◽  
Oyekoya T. Ayonrinde ◽  
Faye Latchmiah ◽  
Syed A. Mukhtar ◽  
...  
Keyword(s):  
Blood Cell ◽  
Gastrointestinal Bleeding ◽  
Red Blood Cell ◽  
Upper Gastrointestinal Bleeding ◽  
Fresh Frozen Plasma ◽  
Red Blood Cell Transfusion ◽  
Fresh Frozen ◽  
Upper Gastrointestinal ◽  
Frozen Plasma

The bleeding patient

2014 ◽  
Author(s):  
Anthea Hatfield
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Disseminated Intravascular Coagulation ◽  
Oxygen Supply ◽  
Final Section ◽  
Fresh Frozen Plasma ◽  
Blood Transfusions ◽  
Massive Blood Transfusion ◽  
Fresh Frozen ◽  
Frozen Plasma

Part one of this chapter tells you about the physiology of blood and oxygen supply, about anaemia and tissue hypoxia, and the physiology of coagulation. Drugs that interfere with clotting are discussed. Bleeding, coagulation, and platelet disorders are covered as well as disseminated intravascular coagulation. Part two is concerned with bleeding in the recovery room: how to cope with rapid blood loss, managing ongoing blood loss, and how to use clotting profiles to guide treatment. There is also a section covering blood transfusion, blood groups and typing. Massive blood transfusion is clearly described, there are guidelines about when to use fresh frozen plasma, when to use platelets, and when to use cryoprecipitate. The final section of the chapter is about problems with blood transfusions.

scholarly journals Red Cell, Plasma and Albumin Transfusion Decision Triggers

1993 ◽  
Vol 21 (2) ◽  
pp. 156-162 ◽  
Author(s):  
M. D. Nicholls ◽  
G. Whyte
Keyword(s):  
Decision Making ◽  
Blood Loss ◽  
Fresh Frozen Plasma ◽  
Red Cell ◽  
Coagulation Test ◽  
Cell Plasma ◽  
Fresh Frozen ◽  
Red Cell Transfusion ◽  
Specialist Groups ◽  
Frozen Plasma

Hypothetical clinical cases were used to investigate transfusion-related decision-making. Three red cell, three fresh frozen plasma (FFP) and three albumin transfusion decision cases were administered by questionnaire to 228 medical staff. The transfusion decision triggers were identified and comparisons made between resident and specialist groups and between Melbourne and Sydney participants. Factors important in red cell transfusion decisions included haemoglobin, symptoms of anaemia, presence of co-morbidities or surgery, gender, period of hospitalisation and the degree of documented blood loss. FFP administration was influenced by an abnormal coagulation test, the presence of co-morbidities and by the number of red cell units transfused. The administration of albumin, concentrated or 5% SPPS, was influenced by the period of hospitalisation and clinical circumstances such as a falling urine output postoperatively, and by the presence of hypotensive complications. Different transfusion responses were noted: resident staff transfused red cells and FFP earlier than specialists; Sydney specialists were more conservative of red cell transfusion; Melbourne specialists more conservative of FFP administration and surgeons were four times more likely to transfuse patients than physicians or anesthetists at certain haemoglobin values.

Blood loss in infants and children for open heart operations: albumin 5% versus Fresh-Frozen plasma in the prime

2003 ◽  
Vol 75 (5) ◽  
pp. 1506-1512 ◽  
Author(s):  
William C Oliver ◽  
Froukje M Beynen ◽  
Gregory A Nuttall ◽  
Darrell R Schroeder ◽  
Mark H Ereth ◽  
...  
Keyword(s):  
Blood Loss ◽  
Fresh Frozen Plasma ◽  
Infants And Children ◽  
Open Heart ◽  
Fresh Frozen ◽  
Frozen Plasma ◽  
In Infants And Children

scholarly journals Blood Loss and Transfusion Requirements in Liver Transplantation: Experience with the First 75 Cases

1994 ◽  
Vol 22 (6) ◽  
pp. 666-671 ◽  
Author(s):  
P. L. Mcnicol ◽  
G. Liu ◽  
I. D. Harley ◽  
P. R. Mccall ◽  
G. M. Przybylowski ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Blood Loss ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Surgical Techniques ◽  
Fresh Frozen Plasma ◽  
Transfusion Requirements ◽  
Fresh Frozen ◽  
The Mean ◽  
Frozen Plasma

The blood loss data and transfusion requirements including blood bank, salvaged washed red cells, fresh frozen plasma and cryoprecipitate were analysed for the first 75 cases of liver transplantation performed at the Austin Hospital between June 1988 and October 1992. The mean blood loss was 8.8 litres (standard deviation 14.1) with a median value of 4.0 litres. Blood product use expressed as mean number of units (SD) was bank red blood cells 7.1 (12.7), washed red blood cells 3.9 (5.9), fresh frozen plasma 7.1 (9.1), platelets 5.1 (7.4), and cryoprecipitate 1.7 (5.1). These results demonstrate that liver transplantation can be performed without imposing excessive demands on blood transfusion services. Management should include surgical techniques to minimize bleeding and use of autologous transfusion. Use of component therapy (FFP, platelets and cryoprecipitate) should not be empirical. It should be selective on the basis of clinical bleeding assessment and guided by results of the laboratory coagulation profile and changes in thrombelastographic (TEG) parameters.

Sign in / Sign up

Export Citation Format

Share Document