Ascitic fluid filtration and intravenous infusion versus total-volume paracentesis with infusion of plasma expander in cirrhosis with tense or intractable ascites.
Article
in English
| IMSEAR
| ID: sea-65266
ABSTRACT
BACKGROUND:
Patients with cirrhotic ascites have low serum albumin levels, and paracentesis of ascitic fluid could compromise them further.AIM:
We compared the therapeutic efficacy of ascitic fluid filtration and concentrate infusion (AFI) versus total-volume paracentesis (TVP) with colloid infusion in control of tense or intractable cirrhotic ascites.METHODS:
Ten patients underwent AFI; their ascitic fluid was filtered repeatedly through hollow-fiber hemodialyzer, and the concentrate reinfused intravenously. In ten patients TVP was done with simultaneous intravenous colloid infusion. Follow-up was done weekly and the study terminated if the patient needed diuretics or developed complications.RESULTS:
Pre-study parameters were similar in the two groups. In the AFI and TVP groups, the duration of procedure was median 12 hours and 5.5 hours; fluid removed by paracentesis was 10.2 L and 8.0 L, respectively; and fluid infused intravenously was 0.5 L [with mean (SD) protein content 5.7 (1.3) g/dl] and 1.1 L, respectively. Glomerular filtration rates were lower than normal in the two groups but did not change significantly with the procedure; body weight remained significantly lower up to week 3 and week 2, respectively. The study was terminated at median week 3 (range 1-8) and week 2 (1-4), respectively. Fever was an accompaniment of AFI and one patient developed peritonitis.CONCLUSION:
Patients undergoing AFI remained diuretic-free longer; the procedure is cost-effective but needs to be further evaluated to minimize the side-effects.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Ascites
/
Body Weight
/
Infusions, Intravenous
/
Female
/
Humans
/
Male
/
Ultrafiltration
/
Random Allocation
/
Plasma Substitutes
/
Polygeline
Type of study:
Controlled clinical trial
Language:
English
Year:
1998
Type:
Article
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