Hematologic management of gastrointestinal bleeding

The hematologic management of gastrointestinal (GI) bleeding requires evalu ation of the underlying cause of bleeding, associated diseases that can exa cerbate the bleeding, and identification of related and unrelated coagulati on abnormalities. Erythrocyte transfusions are given to increase oxygen car rying capacity; however, there is limited information on the level of anemi a that places a patient at increased risk of adverse events after a GI blee d and when patients should receive erythrocyte transfusion. Isolated thromb ocytopenia is uncommon in patients with GI bleeding, and there is little ev idence documenting the degree of thrombocytopenia associated with an increa sed risk of bleeding. Platelets are often administered when the count is 50 ,000 per cu/mL in a bleeding patient. The coagulopathy of liver disease is the most common abnormality seen in the setting of GI bleeding. Fresh-froze n plasma (FFP) should be given in a dose equivalent to the underlying abnor mality and the common practice of administering 2 units of FFP is often ins ufficient in a bleeding patient.