title: Effects of large-volume paracentesis on pulmonary function in patients with tense cirrhotic ascites.
abstract: Large-volume paracentesis is an accepted therapeutic modality for the treatment of tense ascites in patients with cirrhosis. Whereas the effects of large-volume paracentesis on the cardiovascular system have been studied in great detail, the effects of tense ascites and large-volume paracentesis on the respiratory system have undergone only limited evaluation. Most patients report symptomatic improvement in breathing after large-volume paracentesis. The aim of our study was to prospectively evaluate the effects of large-volume paracentesis on the pulmonary function of patients with tense ascites. Nine patients with alcoholic cirrhosis and tense ascites underwent large-volume paracentesis (mean, 3,500 ml of ascites removed) followed by intravenous albumin infusion (10 gm/L ascites removed). Pulmonary function tests were performed just before and 2 hr after large-volume paracentesis. The functional residual capacity increased from 2.46 +/- 0.92 to 2.99 +/- 0.97 L (p = 0.01) and total lung capacity from 5.08 +/- 1.18 to 5.72 +/- 1.32 L (p = 0.03). The forced vital capacity, expiratory reserve volume and residual volume also increased but were not statistically significant (p = 0.07 for all). We noted no significant improvement in forced expiratory volume in 1 sec, forced expiratory effort 25% to 75%, vital capacity or diffusion capacity. There was marked symptomatic improvement in all patients. We conclude that large-volume paracentesis improves measured lung volumes within hours in patients with tense ascites.
authors.affiliation: Department of Medicine, Brooke Army Medical Center, San Antonio, Texas.
authors.forename: C E
authors.initials: CE
authors.lastname: Angueira
authors.forename: S C
authors.initials: SC
authors.lastname: Kadakia
mesh_terms: D001201:Ascites / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D011677:Punctures; D012129:Respiratory Function Tests; D013396:Suction