Life-threatening haemorrhage - 2014
Life-threatening haemorrhage can be defined in many aspects: by extent of blood loss- loss of blood volume during 24 hours (in an adult of about 10 units of RBC transfusion) or a loss of 50% of blood volume during three hours or continuous blood loss of over 150 ml / min; 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. CNS).
Review
Upper gastrointestinal bleeding can be potential source of life-threatening bleeding. This algorithm is focused on treatment of life-threatening bleeding in patient with upper gastrointestinal bleeding in portal hypertension. Algorithm comprehensively describes the prehospital and hospital approach to patients with severe bleeding from the upper gastrointestinal tract. All is based on guidelines for the diagnosis and treatment of gastrointestinal bleeding in portal hypertension, which was made by Czech Hepatology Society and guidelines for therapy of life-threatening bleeding from European Society of Anaesthesiology. The main goal for treatment of patient with upper gastrointestinal bleeding, and actually of each patient with life-threatening bleeding, is to secure vital functions, stop the bleeding and sufficiently substitute the blood loss. This approach is well described in this algoritm.
Sources
KASAL, Eduard. Život ohrožující krvácení. Anesteziologie & intenzivní medicína. 2005, 16(6), 279. ISSN 1214-2158.
PENKA, Miroslav, Igor PENKA a Jaromír GUMULEC. Krvácení. Praha: Grada, 2014. ISBN 978-80-247-0689-4.
