Clin Mol Hepatol.
2015 Dec;21(4):365-371. 10.3350/cmh.2015.21.4.365.
The impact of paracentesis flow rate in patients with liver cirrhosis on the development of paracentesis induced circulatory dysfunction
- Affiliations
-
- 1Department of Hepatology, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt. asebaey@liver-eg.org
- 2Department of Clinical Biochemistry, National Liver Institute, Menoufia University, Shebeen El-Kom, Egypt.
- KMID: 2359818
- DOI: http://doi.org/10.3350/cmh.2015.21.4.365
Abstract
- BACKGROUND/AIMS
Ascites is a dreadful complication of liver cirrhosis associated with short survival. Large volume paracentesis (LVP) is used to treat tense or refractory ascites. Paracentesis induced circulatory dysfunction (PICD) develops if no plasma expanders are given with ominous complications. To study the effect of ascites flow rate on PICD development.
METHODS
Sixty patients with cirrhosis and tense ascites underwent LVP of 8 L were randomized into 3 equal groups of different flow rate extraction; group I (80 mL/minute), group II (180 mL/minute) and group III (270 mL/minute). Plasma renin activity (PRA) was measured baseline and on day six. PICD was defined as increase in PRA >50% of the pretreatment value.
RESULTS
In group I through 3; the mean age was (52.5±9.4 vs. 56.4±8.5 vs. 55.8±7.1 years; P>0.05), mean arterial pressure (81.4±5.6 vs. 81.5±7 vs. 79.5±7.2 mmHg; P>0.05), MELD (17.6±4.1 vs. 15.8±4.1 vs. 14.7±4.5). Baseline PRA was comparable (1,366.0±1244.9 vs. 1,151.3±1,444.8 vs. 951.9±1,088 pg/mL; P>0.05). There was no statistically significant (P>0.05) flow mediated changes (Delta) of creatinine (0.23±0.27 vs. 0.38±0.33 vs. 0.26±0.18 mg/dL), MELD (1.25±5.72 vs. 1.70±2.18 vs. 1.45±2.21) or PRA (450.93±614.10 vs. 394.61±954.64 vs. 629.51±1,116.46 pg/mL). PICD was detected in a similar frequency in the three groups (P>0.05). On univariate logistic analysis only female sex was a fairly significant PICD predictor (Wald 3.85, odds ratio 3.14; P=0.05).
CONCLUSIONS
The ascites flow rate does not correlate with PICD development.
MeSH Terms
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- What we know about paracentesis induced circulatory dysfunction?
- Management of refractory ascites
- The Efficacy of Hydroxyethyl Starch as Plasma Expander in Cirrhotic Patients with Tense Ascites Treated with Large Volume Paracentesis
- Large volume paracentesis and albumin infusion in patients with cirrhosis ascites
- Successful Transcatheter Arterial Embolization of Abdominal Wall Hematoma from the Left Deep Circumflex Iliac Artery after Abdominal Paracentesis in a Patient with Liver Cirrhosis: Case Report and Literature Review
