Oshita et al defined criteria for grading the severity of upper gastrointestinal hemorrhage. The authors are from Yamaguchi and Kyoto Prefecture Universities in Japan.



(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.



• 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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