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Overview :
The Adjusted Blood Requirement Index (ABRI) can be used to
evaluate a patient with upper gastrointestinal bleeding in the setting of
portal hypertension.
Parameters:
(1) initial hematocrit in percent (as a whole number from 0
to 100)
(2) final hematocrit in percent (as a whole number from 0 to
100)
(3) number of units of blood transfused
ABRI =
= (number of units of packed RBCs transfused) / ((final
hematocrit) - (initial hematocrit) + 0.01)
where:
• The 0.01 is
allows for the initial and final hematocrits are the same.
• The
hemoglobin and hematocrit should be monitored every 6 hours for the first 2
days then every 12 hours until the bleeding is under control.
• The target
hematocrit for a patient without cardiopulmonary disease who has had active GI
bleeding is 24 percent (a hemoglobin of 8 g/dL).
Interpretation:
• minimum ABRI:
a negative number
• maximum ABRI:
> 100
• The typical
ABRI for transfusion after bleeding is controlled is around 0.33. (A single
unit of packed RBCs will raise the hemoglobin 1 g/dL in the absence of blood
loss.)
• An ABRI >= 0.75 indicates that active bleeding is still
occurring.
NOTE: A negative number (when initial hematocrit > final
hematocrit) probably also indicates a failure to control hemorrhage.
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