Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-12

12_GI Bleeding

Pdf Summary

The document presents a case study on gastrointestinal (GI) bleeding discussed at the 2024 Society of Critical Care Medicine. The case involves a 75-year-old female presenting with hematemesis, leading to questions on access choice and bolus fluid selection. It highlights a study showing a better survival rate with a restrictive transfusion strategy. The most common causes of upper GI bleeds are discussed, along with the etiology and diagnosis percentages for both upper and lower GI bleeds. Risk stratification scores and their role in predicting prognosis are mentioned, including the Blatchford and Rockall scores. The importance of early endoscopy and therapy for peptic ulcers to reduce rebleeding and mortality is emphasized. The document also addresses the management of lower GI bleeds and risk factors for mortality in UGI and LGI bleeds. Additionally, it touches on variceal bleed management, including initial steps, drug therapies, and considerations for TIPS procedure. A case complicating anticoagulant therapy in GI bleeding is presented, raising questions on resuming anticoagulation. Ultimately, the document provides a comprehensive overview of the management and treatment options for GI bleeding cases in critical care settings.

Keywords

gastrointestinal bleeding

hematemesis

restrictive transfusion strategy

peptic ulcers

upper GI bleeds

lower GI bleeds

risk stratification scores

Blatchford score

Rockall score

variceal bleed management

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