Following a severe brain injury the goal of the clinician is to prevent secondary brain injury. This entails increasing oxygen delivery to the brain by preventing hypoxia and increasing cerebral perfusion. Hyperosmolar therapy, including mannitol and hypertonic saline, is often used to decrease ICP.
Haney Mallemat, MD
When patients present to the Emergency Department with acute upper GI bleeding, the natural inclination is to quickly pull the transfusion trigger. However, a 2013 study gives us pause:
Antibiotic use in patients with upper GI bleeding and concomitant liver cirrhosis is standard of care. However, have you ever wondered where that recommendation comes from and what exactly the benefits are?