Sujets)
Adulte , Adulte d'âge moyen , Humains , Mâle , Femelle , Péritonite/microbiologie , Ascites/complications , Infections bactériennes , Cirrhose du foie/complications , Péritonite/complications , Péritonite/diagnostic , Péritonite/mortalité , Pronostic , Récidive , Chili , Taux de survie , Études prospectives , Cirrhose alcoolique/complicationsRésumé
We randomized 31 cirrhotic patients with tense ascites to a Group A receiving only diuretic therapy (spironolactone, furosemide, n = 14) or a Group B treated with paracentesis and intravenous albumin infusion (n = 17). Ascites was elminated in 88% of patients in Group B compared to 57% of patients in Group A (p < 0.05). Complications developed in 4 patients in Group A and 2 patients in Group B. Paracentesis was associated to a mild and transient reduction in mean arterial pressure and a significant rise in urinary output. Duration of hospital stay was 5 ñ 3 days in Group B and 22 ñ 6 Group A (p < 0.001). Survival and likelihood of rreadmission for ascites was similar in both groups. Our results suggest that paracentesis plus intravenous albumin infusion is a fast, safe and effective therapy for tense ascites in cirrhotic patients