(6 weeks) and a lower rate of rebleeding than
did those who were treated with the liberal
strategy.37 In this study, portal circulation
pressures increased significantly among patients
in the liberal-strategy group. Although
there are no similar studies addressing changes
in coag ulopathy or thrombocytopenia, it
seems sensible to adopt a restrictive approach
to the use of fresh-frozen plasma and platelets
in patients with acute upper gastrointestinal
bleeding. The role of tran examic acid in patients
with gastrointestinal bleeding is under
investigation in the ongoing randomized, controlled
Hemorrhage Alleviation with Tranexamic
Acid–Intestinal System (HALT-IT) trial
(NCT01658124). In patients with liver disease
and laboratory tests indicating abnormal synthesis
of coagulation factors, vitamin K should
be routinely administered to aid in the synthesis
of coagulation factors.