A comparative study of paracenthesis of massive ascites in cirrhotic patients with and without using intravenous albumin

Abstract

Introduction: It has been shown that repeated large volume paracenthesis associated with intravenous albumin infusion is a rapid, effective and safe therapy of massive ascites in cirrhosis. Our aim was to investigate wether IV infusion of albumin is necessary in large volume paeacenthesis therapy of cirrhotic ascites. Methods: 37 patients with tense cirrhotic ascites who were intractable to diuretic therapy were randomly assigned in two groups. 16 patients (group A) were treated with paracenthesis of 4 lit/day plus intravenous albumin infusion (7 gr/lit), and 21 (group B) with paracenthesis without albumin infusion. Hemodynamic status, liver and kidney function and serum lectrolytes were assessed before, while and after paracenthesis. Results: Paracenthesis without IV albumin did not induce significant changes in standard renal function tests, serum albumin, serum electrolytes and liver function tests. One patient from each group developed renal impairment. Two patients from group A and 3 from group B developed asymptomatic hyponatermia. One patient from group A died due to hepatic encephalopathy during paracenthesis. Conclusion: Intravenous albumin infusion is not necessary during large volume paracenthesis for treatment of tense ascites in cirrhotic patients.

Keywords

• Paracenthesis
• Massive ascites