Textbook of Hepatology 2007
DOI: 10.1002/9780470691861.ch7c
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Clinical Manifestations and Management of Bleeding Episodes in Cirrhotics

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Cited by 10 publications
(27 citation statements)
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“…An important part of the treatment of variceal bleeding is the general management of hypovolemic shock, in which blood volume replacement represents a crucial step. 1 However, there is little information on how blood volume restitution should be done. There is a general concern as to avoiding over transfusion, 1,2 since it is known that plasma volume expansion increases portal pressure in patients with portal hypertension.…”
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confidence: 99%
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“…An important part of the treatment of variceal bleeding is the general management of hypovolemic shock, in which blood volume replacement represents a crucial step. 1 However, there is little information on how blood volume restitution should be done. There is a general concern as to avoiding over transfusion, 1,2 since it is known that plasma volume expansion increases portal pressure in patients with portal hypertension.…”
mentioning
confidence: 99%
“…1 However, there is little information on how blood volume restitution should be done. There is a general concern as to avoiding over transfusion, 1,2 since it is known that plasma volume expansion increases portal pressure in patients with portal hypertension. [3][4][5] The blood volume dependency of portal pressure is further illustrated by the fact that depletion of blood volume during hemorrhage or lymph drainage lowers portal pressure.…”
mentioning
confidence: 99%
“…4 This has been thereafter confirmed by other studies, 6 emphasizing the concept that pharmacological treatment represents the optimal therapy in the subgroup of patients achieving such a pronounced decrease in HVPG. [1][2][3][4] Unfortunately, there is no adequate noninvasive way of assessing the HVPG response to treatment, which calls for repeated invasive hemodynamic studies.Several endoscopic findings, such as the size of the varices and the presence of red color signs (which are thought to reflect a reduced thickness of variceal wall) show a significant correlation with the risk of bleeding. 1,7,8 These are some of the main determinants of variceal wall tension, 7 which is believed to play a key role in determining variceal rupture.…”
mentioning
confidence: 99%
“…[1][2][3][4] Unfortunately, there is no adequate noninvasive way of assessing the HVPG response to treatment, which calls for repeated invasive hemodynamic studies.…”
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confidence: 99%
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