Objective To explore the application of bicarbonate Ringer's solution (BRS) in the treatment of cirrhosis patients with upper gastrointestinal bleeding. Methods A total of 62 cirrhosis patients at Child‑Pugh class B with upper gastrointestinal bleeding who underwent conservative treatment in the intensive care unit (ICU) were selected. According to the random number table method, they were divided into two groups (n=31): a BRS group and a lactated Ringer's solution (LRS) group. Upon ICU admission, the patients were infused with corresponding crystalloid fluids. Their general information (sex, age, and body mass index), as well as blood gas results [lactate, base excess (BE), pH, HCO3−, and hemoglobin] and mean arterial pressure (MAP) were recorded before infusion (T0), at post‑infusion 24 h (T1), 48 h (T2) and 72 h (T3). Meanwhile, the length of ICU stay, norepinephrine usage, and the volumes of crystalloids, colloids, and blood transfusions within 72 h, as well as alanine aminotransferase (ALT), aspartate aminotransferase (AST), ammonia levels, and the Mini‑Mental State Examination (MMSE) scores at T0 and T3, were measured. Results The BRS group showed decreases in the length of ICU stay and norepinephrine usage within 72 h, decreases in lactate at T2 and T3, ALT and AST at T3 (all P<0.05), and increases in BE, pH, and HCO3− at T1, T2, and T3, compared with the LRS group (all P<0.05). Compared with those at T0, the BRS group presented decreases in lactate at T2 and T3 (all P<0.05), and increases in BE, pH, and HCO3− at T1, T2, and T3 (all P<0.05); the LRS group presented increases in lactate at T2 and T3 (all P<0.05), decreases in BE, pH, and HCO3− at T2 and T3 (all P<0.05), and increases in ALT and AST at T3 (all P<0.05). Both groups showed increases in hemoglobin and MAP at T1, T2, and T3 (all P<0.05). Compared with those at T1, the BRS group showed decreases in lactate and increases in BE, pH, and HCO3− at T2 and T3 (all P<0.05); the LRS group showed increases in lactate at T2 and T3 (all P<0.05), decreases in BE and HCO3− at T2 and T3 (all P<0.05), and decreases in pH at T3 (P<0.05). Compared with those at T2, the BRS group showed increases in BE, pH, and HCO3− at T3 (all P<0.05); the LRS group showed increases in lactate at T3 (P<0.05), and decreases in BE, pH and HCO3− at T3 (all P<0.05). There were no statistical differences in other indicators (all P>0.05). Conclusions The infusion of BRS in cirrhosis patients with upper gastrointestinal bleeding is more effective in reducing lactate, stabilizing BE, pH, and HCO3−, and minimizing the usage for vasopressors and alleviating hepatic injury. It also shortens the length of ICU stays and improves patient prognosis.