title: Rethinking the role of non-selective beta blockers in patients with cirrhosis and portal hypertension.
abstract: Non-selective beta blockers (NSBB) are commonly used to prevent portal hypertensive bleeding in cirrhotics. Nevertheless, in the last years, the use of NSBB in critically decompensated patients, especially in those with refractory ascites, has been questioned, mainly for an increased risk of mortality and worsening of systemic hemodynamics. Moreover, even if NSBB have been reported to correlate with a higher risk of renal failure and severe infection in patients with advanced liver disease and hypotension, their use has been associated with a reduction of risk of spontaneous bacterial peritonitis, modification of gut permeability and reduction of bacterial translocation. This manuscript systematically reviews the published evidences about harms and benefits of the use of NSBB in patients with decompensated cirrhosis.
authors.affiliation: Alberto Ferrarese, Alberto Zanetto, Giacomo Germani, Patrizia Burra, Marco Senzolo, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ferrarese
authors.affiliation: Alberto Ferrarese, Alberto Zanetto, Giacomo Germani, Patrizia Burra, Marco Senzolo, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanetto
authors.affiliation: Alberto Ferrarese, Alberto Zanetto, Giacomo Germani, Patrizia Burra, Marco Senzolo, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Germani
authors.affiliation: Alberto Ferrarese, Alberto Zanetto, Giacomo Germani, Patrizia Burra, Marco Senzolo, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.affiliation: Alberto Ferrarese, Alberto Zanetto, Giacomo Germani, Patrizia Burra, Marco Senzolo, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Senzolo
keywords: Ascites; Beta blockers; Cirrhosis; Portal hypertension