title: The Palliative Management of Refractory Cirrhotic Ascites Using the PleurX (©) Catheter.
abstract: Background. Treatment options are limited for patients with refractory cirrhotic ascites (RCA). As such, we assessed the safety and effectiveness of the PleurX catheter for RCA. Methods. A retrospective analysis was performed on all patients with RCA who have undergone insertion of the PleurX catheter between 2007 and 2014 at our clinic. Results. Thirty-three patients with RCA were included in the study; 4 patients were lost to follow-up. All patients were still symptomatic despite bimonthly large volume paracentesis and were not candidates for TIPS or PV shunt. Technical success was achieved in 100% of patients. The median duration the catheter remained in situ was 117.5 days, with 95% CI of 48-182 days. Drain patency was maintained in 90% of patients. Microorganisms consistent with spontaneous bacterial peritonitis (SBP) from a catheter source were isolated in 38% of patients. The median time to infection was 105 days, with 95% CI of 34-233 days. All patients were treated for SBP successfully with antibiotics. Conclusion. Use of the PleurX catheter for the management of RCA carries a high risk for infection when the catheter remains in situ for more than 3 months but has an excellent patency rate and did not result in significant renal injury.
authors.affiliation: Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada K1Y 4E9.
authors.forename: Jason
authors.initials: J
authors.lastname: Reinglas
authors.affiliation: Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada K1Y 4E9.
authors.forename: Kayvan
authors.initials: K
authors.lastname: Amjadi
authors.affiliation: Department of Epidemiology and Community Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada K1Y 4E9.
authors.forename: Bill
authors.initials: B
authors.lastname: Petrcich
authors.affiliation: Department of Epidemiology and Community Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada K1Y 4E9.
authors.forename: Franco
authors.initials: F
authors.lastname: Momoli
authors.affiliation: Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada K1Y 4E9.
authors.forename: Thomas
authors.initials: T
authors.lastname: Shaw-Stiffel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D016208:Databases, Factual; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010538:Peritonitis / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome