Interventional Algorithm in Gastrointestinal Bleeding—An Expert Consensus Multimodal Approach Based on a Multidisciplinary Team
Anabela Rodrigues, MD 1); Alexandre Carrilho, MD 2); Nuno Almeida, MD, PhD 3); Cilénia Baldaia, MD 4); Ângela Alves, MD 5); Manuela Gomes, MD 6); Luciana Gonçalves, MD 7); António Robalo Nunes, MD, PhD 8); Carla Leal Pereira, MD 1); Mário Jorge Silva, MD 9); José Aguiar, MD 10); Rosário Orfão, MD 11); Pedro Duarte, MD 9); and Rui Tato Marinho, MD, PhD 4)
1 – Transfusion Medicine Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
2 – Anesthesiology Department, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
3 – Gastroenterology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
4 – Gastroenterology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
5 – Anesthesiology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
6 – Transfusion Medicine Department, Hemovida, Lisbon, Portugal
7 – Transfusion Medicine Department, Centro Hospitalar Universitário de São João, Porto, Portugal
8 – Transfusion Medicine Department, Hospital das Forças Armadas, Lisbon, Portugal
9 – Gastroenterology Department, Hospital Santo António dos Capuchos, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
10 – Anesthesiology Department, Hospital Lusíadas, Porto, Portugal
11 – Anesthesiology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
Abstract
The approach to the patient with gastrointestinal bleeding (GIB) can be very complex. A multidisciplinary panel of physicians with expertise in Gastroenterology, Anesthesiology, and Transfusion Medicine worked together to provide the best knowledge and guide clinical practitioners in the real setting of health institutions, characterized by disparate availability of human and technical resources. The authors propose a global and personalized approach according to different clinical scenarios to improve the outcomes of patients with GIB, for whom the reduction of inappropriate transfusions is crucial. The goal of this document is to provide clear and objective guidance through interventional algorithms toward a goal-directed approach according to the clinical situation and supported by the latest available scientific data on GIB management in different settings.