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Variceal Hemorrhage

  • Elizabeth A. BelloliEmail author
  • Steven E. Gay
Chapter
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Abstract

Acute variceal hemorrhage is one of the most common reasons for intensive care unit admission of patients with cirrhosis, with mortality rates improved in recent years to 15–20%. Patients with variceal bleeding require immediate and aggressive resuscitation, with the goals of maintaining end-organ perfusion and achieving hemostasis as soon as possible. The critical care practitioner must be familiar with recommended medications and transfusion parameters, and indications for more invasive procedures should endoscopic measures fail to halt bleeding. Complications such as infection and hepatic encephalopathy should be given attention. In this chapter, we discuss typical management of a patient with suspected variceal bleeding and more controversial aspects in their care.

Keywords

Varices Bleeding Cirrhosis Vasoconstrictors Resuscitation Intubation Coagulopathy Surgery TIPS BRTO 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Pulmonary and Critical Care MedicineUniversity of Michigan Health SystemAnn ArborUSA

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