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The concept of the low sensitivity of initial Hct for the detection of severe bleeding has recently been challenged.
Severe bleeding has occurred at primary sites of malignant disease, such as PH in NSCLC patients and GI bleeding in CRC patients.
However, severe bleeding has also been described at sites not primarily involved with cancer, such as GI bleeding in patients without CRC, and CNS bleeding in patients without known brain metastases (Johnson et al, 2004; Sandler et al, 2006).
The main disadvantage of CRRT is the requirement for anticoagulation to prevent clotting of the extracorporeal circuit, and severe bleeding has been reported in up to 30% of these patients, with heparin being the most commonly used anticoagulant [ 7, 8].
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Experts said it was unusual that severe bleeding had begun so long after an operation.
However, cases of severe and life-threatening bleeding have been reported in the medical literature.
To date, the utility of VCE in acute severe GI bleeding has been analyzed rarely.
Since Lasix was introduced in New York in 1995, severe, visible bleeding has been reduced by 76 percent.
A Sengstaken-Blakemore tube applied for severe oesophageal variceal bleeding has had considerable complications, including deaths, reported from oesophageal rupture after inadvertent inflation of the gastric balloon in the oesophagus [247].
An increased risk of severe (grade ⩾3) bleeding has also been reported with bevacizumab treatment.
If arterial or severe venous bleeding had been present, it would have been of primary importance to secure the airway and then confront the source of bleeding.
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