Modern-day management of upper gastrointestinal haemorrhage.
Jairath V., Desborough MJ.
Acute upper gastrointestinal haemorrhage (AUGIH) is a common medical emergency and can present with life threatening haemorrhage. In the U.K., there are 70,000 hospital admissions per year. In the majority of cases, the aetiology is non-variceal in origin, but in other cases it is due to variceal bleeding in patients with cirrhosis. It is also a leading indication for transfusion of blood components. This review explores recent randomised data on the efficacy and safety of red blood cell transfusion for AUGIH. In addition, the evidence base for use of other blood components and pro-haemostatic pharmacological agents is discussed, including acid suppression, antifibrinolytics and fibrinogen.