title: Prevention of paracentesis-induced circulatory dysfunction in cirrhosis: standard vs half albumin doses. A prospective, randomized, unblinded pilot study.
abstract: BACKGROUND
  Paracentesis-induced circulatory dysfunction is a well-known complication of large volume paracentesis. Albumin infusion (8g of albumin/L of ascites removed) is effective in preventing it, but high costs and scant availability limit its use.
  
  
  OBJECTIVE
  To compare standard vs half albumin doses.
  
  
  METHODS
  Seventy cirrhotic patients treated with large volume paracentesis were randomized to receive intravenous albumin as prevention of paracentesis-induced circulatory dysfunction: group 1 (35 patients) received 4g/L of ascites removed, group 2 (35 patients) received 8g/L of ascites removed.
  
  
  RESULTS
  The incidence of paracentesis-induced circulatory dysfunction (14% vs 20% in group 1 and group 2, respectively; p=ns), hyponatremia (9% vs 6%, p=ns) and renal impairment (0% in both groups) on the 6th day from paracentesis was similar between the two groups. After 6 months of follow-up, rates of survival and of recurrence of ascites requiring large volume paracentesis were not different between the two groups.
  
  
  CONCLUSIONS
  This unblinded, randomized, pilot study suggests that treatment with half doses of albumin is effective in the prevention of paracentesis-induced circulatory dysfunction and its related clinical complications in cirrhotic patients with tense ascites treated by large volume paracentesis. If confirmed, these results could support a significant costs reduction in the management of ascites in cirrhotic patients.
authors: Division of Gastroenterology and Hepatology, San Giovanni Battista Hospital - University of Turin, Turin, Italy. carloalessandria@libero.it
authors: Carlo
authors: C
authors: Alessandria
authors: Chiara
authors: C
authors: Elia
authors: Lavinia
authors: L
authors: Mezzabotta
authors: Alessandro
authors: A
authors: Risso
authors: Alida
authors: A
authors: Andrealli
authors: Maurizio
authors: M
authors: Spandre
authors: Anna
authors: A
authors: Morgando
authors: Alfredo
authors: A
authors: Marzano
authors: Mario
authors: M
authors: Rizzetto
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000008:administration & dosage* / Q000627:therapeutic use; D001201:Ascites / Q000150:complications / Q000628:therapy; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019152:Paracentesis / Q000009:adverse effects*; D010865:Pilot Projects; D010952:Plasma Substitutes / Q000008:administration & dosage* / Q000627:therapeutic use; D012008:Recurrence; D051437:Renal Insufficiency / Q000209:etiology
chemical_list: D000418:Albumins; D010952:Plasma Substitutes