Paracentesis-induced circulatory dysfunction: are there albumin alternatives?

Background Ascites is one of the main complications of advanced liver cirrhosis. It is defined as a pathological accumulation if free fluid in the peritoneal cavity. Main body of the abstract Ascites is a sign of decompensation in patients with liver cirrhosis and is associated with decreased surviv...

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Bibliographic Details
Published in:Egyptian Liver Journal 2020-08, Vol.10 (1), p.39-6
Main Authors: Alsebaey, Ayman, Rewisha, Eman, Waked, Imam
Format: Article
Language:English
Subjects:
Abdomen
Albumin
Ascites
Blood
Care and treatment
Complications and side effects
Contraindications
Diuretics
Drug dosages
Hemodynamics
Hernia
Hypertension
Large volume paracentesis
Liver cirrhosis
Paracentesis-induced circulatory dysfunction
Patient compliance
Patients
Prevention
Risk factors
Sodium
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Summary:Background Ascites is one of the main complications of advanced liver cirrhosis. It is defined as a pathological accumulation if free fluid in the peritoneal cavity. Main body of the abstract Ascites is a sign of decompensation in patients with liver cirrhosis and is associated with decreased survival. Ascites is associated with bad cosmetic figure and poor quality of life. Ascites is a predisposing factor for developing hydrothorax, hernias, diastolic dysfunction, spontaneous bacterial peritonitis, and renal impairment especially hepatorenal syndrome. The main treatment is salt restriction and diuretics. By the time the patient become non-responder and develop tense ascites, abdominal large volume paracentesis is the treatment of choice. Its advantages are rapid, cheap, and 1 day hospitalization. The main drawback is the development of paracentesis-induced circulatory dysfunction (PICD) if no volume expanding drugs are used. PICD is associated with dilutional hyponatremia, renal impairment, so it is considered the silent killer. Albumin infusion is the standard preventive measure but since costly to other alternatives such as colloids, vasoconstrictors or lowering the standard doses of the albumin was studied and is promising. Conclusions This review summarized the effectiveness of other alternative drugs.
ISSN:2090-6218
2090-6226
DOI:10.1186/s43066-020-00047-7