Run Time: 9 minutes
Author: Dr. Donald Stader
Educational Pearls:
- Patients with variceal bleeding are sick at baseline, and come from a very sick patient population with a higher mortality rate.
- Varices occur in a patient with cirrhosis when blood goes through other pathways to get back to the heart – rather than going through the liver.
- Antibiotics help greatly with survival of a variceal bleeder because bacteria translocate from the stomach to the blood.
- If a patient has a Sengstaken-Blakemore tube placed the patient has a high morbidity. If the patient makes it to the ICU a tips procedure is done – a shunt of the liver w/ a catheter that goes around liver and back to the heart.
- If a blood transfusion is given before the pt is in hemorrhagic shock – hemoglobin <7 – the patients mortality rate is increased due to the potential to give the patient and infection.