Bursting with symptoms: A review of palliation of ascites in cirrhosis

LaFond, J; Shah, Neeral L.

doi:10.1002/cld.559

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…Though HE is not a concern with the Denver shunt, there are many potential complications, including occlusion, bleeding, and peritonitis. Additionally, because they are placed less often, it may be difficult to find physicians or centers that feel comfortable to place and manage them [ 16 ].…”

Section: Liver-specific Symptomsmentioning

confidence: 99%

Symptom Management in Patients with Cirrhosis: a Practical Guide

Kaplan

Rosenblatt

2022

Curr Treat Options Gastro

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Purpose of the review Though it is well known that cirrhosis is associated with significant morbidity and mortality, management of symptoms in cirrhosis can be difficult. This review serves to offer practical guidance in the management of liver-specific symptoms of cirrhosis as well as other symptoms with special hepatic considerations. Recent findings We discuss liver-specific symptoms and management, including ascites and refractory ascites, hepatic encephalopathy, pruritus, and muscle cramping. We also discuss the challenges of treating more generalized symptoms in cirrhosis, including pain, depression/anxiety, appetite, and fatigue. Medication management is, especially complex in this population given the altered metabolism of drugs, and we consider some strategies to approach this. Summary With the right tools, provided throughout this review, hepatologists should be well equipped to manage the nuanced liver-specific and generalized symptoms in patients with cirrhosis.

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Section: Liver-specific Symptomsmentioning

confidence: 99%

Symptom Management in Patients with Cirrhosis: a Practical Guide

Kaplan

Rosenblatt

2022

Curr Treat Options Gastro

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“…In a palliative care setting, the management goals are directed at symptom control and improvement in quality of life [ 3 ]. The symptoms produced by ascitic fluid accumulation can include abdominal pain, dyspnoea, nausea, and abdominal distension; symptoms that may be mitigated with procedural intervention [ 4 ]. Current recommendations suggest palliative drainage of ascitic fluid, with a reported symptomatic benefit of 64–100% of patients in a systematic review of 32 original articles [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of ASCITIC Paracentesis on Symptomatic Outcomes in Palliative Patients: 3-Year Experience of a Melbourne Inpatient Palliative Care Unit Using Palliative Care Outcomes Collaboration Assessments

Iyer

Kernick²

2022

Gastroenterology Research and Practice

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Background. Ascites formation is a common occurrence in patients receiving palliative care. This is associated with symptoms that may respond to drainage. Aim. To review and quantify ascites-related symptoms pre- and post-paracentesis to evaluate its benefit in an inpatient palliative care setting. Methods. A retrospective audit of patients admitted to an inpatient palliative care unit who underwent paracentesis between November 2016 to June 2020 was performed. The primary outcome was a symptomatic benefit of paracentesis. Secondary outcomes assessed the associated complications as well as the alterations to functional status. Data were analysed using a paired T-test. Results. 43 instances of ascitic paracentesis were performed on a total of 26 patients. Three patients were excluded from the study due to the technical failure of their paracentesis procedure. There was a mean 0.16-point reduction in pain (95% confidence interval (CI) −0.33 to 0.65), a mean 0.03-point increase in dyspnoea (95% CI −0.51 to 0.46), and a mean 0.32-point reduction in nausea (95% CI −0.09 to 0.74). Conclusions. Ascitic paracentesis in the palliative setting may demonstrate some benefit in managing symptoms associated with ascites. Although the findings of this study did not achieve statistical significance, these results may be substantiated by future studies with larger sample size.

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Palliative Care and Liver Diseases

Larson¹

2018

Textbook of Palliative Care

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Bursting with symptoms: A review of palliation of ascites in cirrhosis

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/8-1-reading-lafond.html a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/8-1-interview-lafond.html the interview with the author

Cited by 7 publications

References 10 publications

Symptom Management in Patients with Cirrhosis: a Practical Guide

Symptom Management in Patients with Cirrhosis: a Practical Guide

The Impact of ASCITIC Paracentesis on Symptomatic Outcomes in Palliative Patients: 3-Year Experience of a Melbourne Inpatient Palliative Care Unit Using Palliative Care Outcomes Collaboration Assessments

Palliative Care and Liver Diseases

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