Large Volume Paracentesis and Intravenous Dextran to Treat Tense Ascites

Sk, Acharya; Balwinder, Singh; Ak, Padhee; Nijhawan, Sandeep; Bn, Tandon

doi:10.1097/00004836-199201000-00008

Cited by 28 publications

(20 citation statements)

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“…The main findings of studies comparing LVP with diuretics in patients with grade 3 ascites are summarized as follows [30][31][32][33][34][35][36]: (1) LVP combined with infusion of albumin is more effective than diuretics and significantly shortens the duration of hospital stay. (2) LVP plus albumin is safer than diuretics, the frequency of hyponatremia, renal impairment, and hepatic encephalopathy being lower in patients treated with LVP than in those with diuretics, in the majority of studies.…”

Section: Grade 3 or Large Ascitesmentioning

confidence: 99%

EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis

Möller¹

2010

Journal of Hepatology

1,410

586

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Section: Grade 3 or Large Ascitesmentioning

confidence: 99%

EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis

Möller¹

2010

Journal of Hepatology

1,410

586

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“…It also has lower frequency of hyponatremia, renal impairment, and hepatic encephalopathy when compared with diuretics. However, there were no differences between the two approaches with respect to hospital readmission or survival [45,55].…”

Section: Intravenous Albuminmentioning

confidence: 86%

Pharmacological Therapy of Ascites

Ajlan¹,

Al–Hamoudi²,

Elsiesy³

2017

Ascites - Physiopathology, Treatment, Complications and Prognosis

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Ascites refer to accumulation of fluids in the peritoneal cavity. Ascites is caused by multiple causes, among which liver cirrhosis is the commonest. Confirming the etiology is the first and most important step toward proper management. Assuming that ascites is always caused by cirrhosis can lead to unnecessarily sending patients with different etiologies for liver transplantation, particularly patients with non-cirrhotic portal hypertension. Calculating serum albumin ascitic gradient is important in differentiating ascites due to portal hypertension from other etiologies. The first-line therapy for ascites in cirrhosis is low salt diet and diuretics. It is important to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) and nephrotoxic medications in these patients.

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“…LVP with albumin is the best treatment option in patients with grade 3 ascites; it is more effective and safer than diuretics as it is associated with less hyponatremia, renal impairment, and hepatic encephalopathy. There were no differences between the two approaches with respect to hospital readmission or survival [71][72][73][78][79][80][81]. LVP is a safe procedure, and the risk of local complications, such as hemorrhage or bowel perforation, is extremely low [29].…”

Section: Single Large Volume Paracentesis (Lvp)mentioning

confidence: 86%

Ascites: Causes, Diagnosis, and Treatment

Amer¹,

Elsiesy²

2017

Liver Cirrhosis - Update and Current Challenges

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Ascites is a pathological accumulation of fluid in the peritoneal cavity. Cirrhosis is the most common cause of ascites, representing for 85% of cases. More than one cause may be responsible for the development of ascites (multifactorial). Development of ascites is a poor prognostic event in the natural history of cirrhosis, with approximately 15 and 44% of patients with ascites succumbing in 1 and 5 years, respectively. Patients with cirrhosis need referral for liver transplantation after development of ascites. Proper history and physical examination are important in diagnosing the cause of ascites. Diagnostic paracentesis and abdominal sonogram should be performed during initial evaluation. Low salt diet and diuretic are the initial treatment option, and large volume paracentesis is an option for non-responder to diuretics. Transjugular intrahepatic portosystemic stent-shunt (TIPS) is highly valuable in properly selected patients.

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Large Volume Paracentesis and Intravenous Dextran to Treat Tense Ascites

Cited by 28 publications

References 0 publications

EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis

EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis

Pharmacological Therapy of Ascites

Ascites: Causes, Diagnosis, and Treatment

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