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Medical management of variceal hemorrhage.
Crit Care Nurs Clin North Am. 2010 Sep; 22(3):381-93.CC

Abstract

Gastroesophageal variceal hemorrhage is a major complication of portal hypertension in 50% to 60% of patients with liver cirrhosis and is a frequent cause of mortality in these patients. The prevalence of variceal hemorrhage is approximately 5% to 15% yearly, and early variceal rebleeding has a rate of occurrence of 30% to 40% within the first 6 weeks. More than 50% of patients who survive after the first bleeding episode will experience recurrent bleeding within 1 year. Management of gastroesophageal varices should include prevention of initial and recurrent bleeding episodes and control of active hemorrhage. Therapies used in the management of gastroesophageal variceal hemorrhage may include pharmacologic therapy (vasoactive agents, nonselective b-blockers, and antibiotic prophylaxis), endoscopic therapy, transjugular intrahepatic portosystemic shunt, and shunt surgery. This article focuses primarily on pharmacologic management of acute variceal hemorrhage.

Authors+Show Affiliations

Critical Care, Department of Pharmacy, Antelope Valley Hospital, 1600 West Avenue, Lancaster, CA 93534, USA. tram.cat@avhospital.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20691388

Citation

Cat, Tram B., and Xi Liu-DeRyke. "Medical Management of Variceal Hemorrhage." Critical Care Nursing Clinics of North America, vol. 22, no. 3, 2010, pp. 381-93.
Cat TB, Liu-DeRyke X. Medical management of variceal hemorrhage. Crit Care Nurs Clin North Am. 2010;22(3):381-93.
Cat, T. B., & Liu-DeRyke, X. (2010). Medical management of variceal hemorrhage. Critical Care Nursing Clinics of North America, 22(3), 381-93. https://doi.org/10.1016/j.ccell.2010.02.004
Cat TB, Liu-DeRyke X. Medical Management of Variceal Hemorrhage. Crit Care Nurs Clin North Am. 2010;22(3):381-93. PubMed PMID: 20691388.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medical management of variceal hemorrhage. AU - Cat,Tram B, AU - Liu-DeRyke,Xi, Y1 - 2010/06/25/ PY - 2010/8/10/entrez PY - 2010/8/10/pubmed PY - 2010/12/14/medline SP - 381 EP - 93 JF - Critical care nursing clinics of North America JO - Crit Care Nurs Clin North Am VL - 22 IS - 3 N2 - Gastroesophageal variceal hemorrhage is a major complication of portal hypertension in 50% to 60% of patients with liver cirrhosis and is a frequent cause of mortality in these patients. The prevalence of variceal hemorrhage is approximately 5% to 15% yearly, and early variceal rebleeding has a rate of occurrence of 30% to 40% within the first 6 weeks. More than 50% of patients who survive after the first bleeding episode will experience recurrent bleeding within 1 year. Management of gastroesophageal varices should include prevention of initial and recurrent bleeding episodes and control of active hemorrhage. Therapies used in the management of gastroesophageal variceal hemorrhage may include pharmacologic therapy (vasoactive agents, nonselective b-blockers, and antibiotic prophylaxis), endoscopic therapy, transjugular intrahepatic portosystemic shunt, and shunt surgery. This article focuses primarily on pharmacologic management of acute variceal hemorrhage. SN - 1558-3481 UR - https://www.unboundmedicine.com/medline/citation/20691388/Medical_management_of_variceal_hemorrhage_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-5885(10)00007-9 DB - PRIME DP - Unbound Medicine ER -