A 45 - year old cirrhotic patient presented with severe haematemesis. The management of choice is :
Ans. is 'a' Whole Blood transfusion "Patients with significant hemorrhage, Anaemia or Intravascular volume depletion require Blood transfusion or colloid containing solutions (albumin, Dextran) but whole blood transfusion is the t/t of choice because colloidal solutions are expensive and they have some adverse effect"T/T of hypovolemia :The therapeutic goals are to restore normovolemia with fluid similar in composition to that lost and to replace ongoing losses.Mild volume contraction can usually be corrected via oral route. More severe hypovolemia requires intravenous therapy. Normonatremic or Mildly - Isotonic or normal saline (0.9% NaCl) and should be hyponatremic individuals administered initially in pts with hypotension or shock.Severe Hyponatremia - Hypertonic Saline (3.0% NaCl)Hypernatremia - Half Normal Saline(0.5% NaCl)If Hypokalemia also occurs - Add appropriate amount of KC1 to replacement solution.Significant haemorrhage, - Whole blood transfusion.Anaemia or IntravascularVolume depletion
Whole blood transfusion is the best
Colloids are preferred over crystalloids
Normal saline infusion
IV fluid with diuretics
Cirrhosis and Alcoholic Liver Disease