-lower mortality with “restrictive” (Hgb 7-9 g/dL) rather than liberal strategy
although you should c/w your blood resuscitation according to hemodynamics
-antibiotic “prophylaxis” reduces mortality
use ceftriaxone rather than quinolone 2/2 increasing resistance
-no need to correct INR with FFP
FFP transfusions may actually be associated with worse outcomes (e.g. inc’d mortality)
-vasoactives (i.e. octreotide, somatostatin, terlipressin) alone may actually control bleeding
-for your ICU boarders...if persistent or severe rebleeding (despite endoscopic therapy), rescue TIPS is therapy of choice (call IR)
References
Zanetto A, Shalaby S, Feltracco P, et al. Recent advances in the management of acute variceal hemorrhage. Journal of Clinical Medicine. 2021;10(17):3818.
