Use of blood component therapy for gastrointestinal bleeding in patients with cirrhosis of the liver.
A prospective study was designed to compare the administration of available fresh blood and component therapy in the treatment of gastrointestinal bleeding in patients with cirrhosis of the liver. Fifty bleeding cirrhotic patients were randomly assigned to treatment: 17 patients recieved 51 percent fresh blood (Group 1), 16 patients received 22 percent fresh blood (Group 2), and 17 patients received 25 percent component therapy consisting of packed cells, fresh frozen plasma, and platelet concentrate (Group 3).  The mortality rate was unaffected by the type of blood replacement.  Neither the blood replacement requirement (Group 1:51 plus or minus 0.9 units Group 2:5.5 plus or minus 0.8 units, Group 3:7.1 plus or minus 1.1 units) nor the duration of bleeding (Group 1:39 plus or minus 0.8 days, Group 2:6.3 plus or minus 2.4 days, Groups 3:5.8 plus or minus 1.0 days) were significantly different.  There was no correlation between the mean age of blood or plasma received and the units of blood replaced or the duration of bleeding.  Patients with severe coagulation abnormalties had a significantly increased mortality.  Component therapy was as effective as the fresh blood regimen in cirrhotic patients with acute gastrintestinal hemorrhage.
D001803:Blood Transfusion; D004932:Esophageal and Gastric Varices / Q000150:complications; D005756:Gastritis / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000401:mortality; D008404:Massachusetts