Value of duplex ultrasound to investigate whether large volume paracentesis without infusions is safe, easy and economic in selected cirrhotic patients

ABSTRACT

In tense or refractory asciites, large volume paracentesis [LVP] combined with intravenous infusions has been suggested as the preferable treatment. Flow volume rate [FVR] of portal vein [PV] and Hepatic artery [HA] were measured before and one day after large volume paracentesis [L VP]. 58 cirrhotic patients with ascites were allocated into 2 groups; group [1] 28 patients were not infused by isotonic fluids, group [2] 30 patients [divided into 3 equal subgroups 2a, 2b and 2c] were infused by different isotonic solutions as follow saline, hemaccel and human albumin respectively. FVR of PV in group 1, 2a, 2b and 2c before LVP were 1894.4+3.3, 1235.5+7.8, 1253.9+19 and 2172+4,2 ml/mm respectively and one day after LVP they were 2207+11,2, 1666+7.4, 1396+29.3 and 1835+8.7 ml/min respectively. FVR of HA in group 1, 2a, 2b and 2c before LVP were 222,7+3.2, 182.3+4.4, 286.4+5.9 and 238,8+4.1 ml/min respectively. FVR of HA in group If 2a, 2b and 2c after LVP were 541.7+4.2, 329.1+2.9, 289,7+1.7 and 284 4+4.2 ml/min respectively, We conclude that FVR was significantly increased after LVP in the majority of the patients; more in patients non infused as compared to infused patients provided we select probably our patients. LVP less than 5 liters without infusions in selected patients are effective, safe, easy and economic. This research was funded by Theodor Bilharz Research Institute [TBRI] and Egyptian Academy of Research and Technology