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Resuscitation in oesophageal variceal bleeding

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The primary aim of resuscitation is replacement of the circulating volume:

  • venous access with a wide-bore cannula is essential

  • central venous access permits measurement of venous pressure and the response to fluid infusions

  • the following investigations should be performed urgently:
    • full blood count
    • clotting profile
    • serum electrolytes

  • volume replacement consists of:
    • colloids (initially)
    • blood
    • fresh-frozen plasma, as a sourve of clotting factors

Excessive volume replacement should be avoided.

If the patient is comatose or is bleeding heavily then endotracheal intubation may be indicated to prevent aspiration.

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