Hemodynamic changes after single large volume paracentesis(SLVP) in cirrhosis with tense ascites: Focusing on the effect of albumin as a plasma expander.
- Author:
Soon Koo BAIK
1
;
Hyun Soo KIM
;
Il Hee KIM
;
Sang Ok KWON
Author Information
1. Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Single large volume paracentesis;
Cirrhosis with tense ascites;
Hemodynamic change;
Albumin administration
- MeSH:
Aldosterone;
Arterial Pressure;
Ascites*;
Creatinine;
Fibrosis*;
Hemodynamics*;
Humans;
Kidney;
Osmolar Concentration;
Paracentesis;
Plasma*;
Renin;
Sodium;
Transcutaneous Electric Nerve Stimulation*;
Vascular Resistance
- From:Korean Journal of Medicine
2000;58(3):276-282
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In patients with cirrhosis, single large volume paracentesis(SLVP) is an effective and safe treatment for the tense ascites. But the need for routine administration of albumin remains controversial. We investigated the necessity of albumin administration in cirrhosis with tense ascites after SLVP. METHODS: 23 patients with cirrhosis with tense ascites were recruited, and examined before and 48 hour after a SLVP. Patients were randomly assigned to be administrated with albumin(6 g/L of ascites removed, n=11) or not(n=12). Systemic and renal hemodynamic parameters(mean arterial blood pressure, cardiac index, systemic vascular resistance index, resistive index of kidney, and serum creatinine), indices associated with sodium homeostasis(urine sodium and osmolarity) and neurohumoral factors such as plasma renin activity and plasma concentration of aldosterone were measured before and 48 hour after a SLVP. RESULTS: There was no significant difference in clinical and laboratory parameters between two groups at entry into the study. Plasma renin activity was significantly increased 48 hour after a SLVP in patients without albumin administration, but the change of plasma renin activity before and after paracentesis((delta)plasma renin activity) was not significantly different between two groups. There was no difference in the mean arterial blood pressure, cardiac index, systemic vascular resistance index, resistive index of kidney, serum creatinine, urine sodium and osmolarity and plasma concentration of aldosterone between two groups after SLVP. CONCLUSION: Single large volume paracentesis without albumin administration is a safe and effective treatment in cirrhosis with tense ascites.
