Optimizing emergency care of upper gastrointestinal bleeding in cirrhotic XXXX .

@entity1 @entity548 @entity1951 @entity8508 @entity2390 @entity1943
The type of emergency treatment administered to @entity1 with suspected @entity548 is important, as the episode is associated with a high mortality rate. Moreover, rebleeding is common during the first few days after the initial @entity548 . Several techniques are available to control variceal @entity548 including pharmacotherapy ( @entity1951 , @entity8508 , @entity1943 and @entity2390 ), balloon tamponade, endoscopic techniques, transjugular intrahepatic portosystemic shunt and shunt surgery. The majority of these require specialized equipment and/or experienced personnel, which are not always available in every hospital. In such situations, pharmacotherapy represents the most practical method of establishing haemodynamic control prior to the administration of definitive treatment. Pharmacotherapy can be initiated immediately upon admission to stabilize the @entity1 prior to diagnostic endoscopy, which subsequently improves the efficacy and ease of administration of further endoscopic intervention. The optimal pharmacological agent should be both effective and safe. A drug with no side effects will not complicate the management of critical @entity1 and can be administered over an extended period to reduce the incidence of rebleeding and improve prognosis. Meta-analysis of clinical studies has revealed that of the vasoactive drugs available @entity1943 is effective with significantly fewer side effects and currently appears to represent the best choice for treatment. The available evidence suggests that the early administration of pharmacotherapy, as part of a specific treatment regimen, offers significant benefit to @entity1 with @entity548 and its administration optimizes emergency care.
