A 45-year-old cirrhotic patient presented with severe hematemesis. The management of choice is:
Initial resuscitation requires rapid re-expansion of the circulating intravascular blood volume along with interventions to control ongoing losses. Continuing acute blood loss, with Hb declining to < 10 g/dL, should initiate blood transfusion, preferably as fully cross-matched recently banked (<14 days old) blood. If severe hypovolemia- norepinephrine, vasopressin, or dopamine required Once hemorrhage is controlled and the patient has stabilized, blood transfusions should not be continued unless the Hb is <~7g/dL.
Whole blood transfusion
Colloids are preferred over crystalloids
Normal saline infusion
IV fluid with diuretics
Cirrhosis