Oshita et al defined criteria for grading the severity of upper gastrointestinal hemorrhage. The authors are from Yamaguchi and Kyoto Prefecture Universities in Japan.
Parameters:
(1) shock
(2) resuscitation fluids required to stabilize
(3) hemoglobin
Criteria for severe hemorrhage (massive bleeding):
(1) presence of shock
(2) fluid required to stabilize either:
(2a) > 1,000 mL of blood and/or plasma expander over 1 hour
(2b) > 2,000 mL of blood and/or plasma expander over 24 hours
(3) hemoglobin <= 8.0 g/dL
Criteria for mild hemorrhage: Any patient without shock.
Criteria for moderate hemorrhage: Any patient not meeting criteria for mild or severe hemorrhage.
Limitations:
• If the person is resuscitated only with plasma expander, then the hemoglobin could very easily be <= 8.0 g/dL because of dilution.
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