A 45-year-old cirrhotic patient presented with severe hematemesis. The management of choice is:: (A) Whole blood transfusion, (B) Colloids are preferred over crystalloids, (C) Normal saline infusion, (D) IV fluid with diuretics
Answer is A. 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.