Hemodynamic changes in patients with liver cirrhosis and tense ascites after large volume paracentesis

الملخص EN

Objective: large volume paracentesis is an effective treatment for resistant ascites but the need for routine infusion of albumin or other volume expanders remains controversial.

The aim of this study was to assess the short term effects of a single 5-L paracentesis without albumin replacement on systemic and portal hemodynamic.

Patients and methods: thirty patients with liver cirrhosis and tense, diuretic resistant ascites were studied before and 24 h after a single 5L paracentesis without albumin infusion.

An abdominal duplex Doppler examination and echocardiography study were carried out for all patients.

Heart rate and blood pressure were measured.

Mean arterial pressure was calculated Serum sodium, potassium, blood urea and creatinine were also measured Results: there were no significant changes from baseline values for heart rate (79.73 ± 8.65 Vs 77.82 ± 7.35), mean arterial pressure (93.17 ± 5.59 Vs 93.35 ±4.13 mmHg) and cardiac output (5.30 ± 0.53 Vs 5.62 ± 0.58 Liter/min).

As regard portal hemodynamic, there were no significant changes in portal vein diameter (10.55 ± 2.82 Vs 10.32 ± 2.75 mm), portal flow velocity (9.13 ± 2.15 Vs 9.22 ± 2.33 cm/sec) and portal blood flow (453 ± 233-90 Vs 482 ± 258.37 ml/min) before and 24 h after large volume paracentesis.

Conclusions: single large volume paracentesis without albumin replacement is safe and satisfactory short term option for management of patients with cirrhosis and tense, diuretic-resistant ascites.