BACKGROUND/AIMS: Postparacentesis circulatory dysfunction is the most severe complication of ascites paracentesis. The aim of our study was to compare the standard treatment with the administration of a vasoconstrictor terlipressin. METHODOLOGY:Forty-nine patients treated by paracentesis due to tense ascites were randomized for the treatment with albumin (8g/L of removed ascites) or terlipressin (1 mg every four hours for 48 hours). The blood pressure, heart rate, diuresis, electrocardiograph, standard biochemical and hematological parameters, sodium, potassium and nitrogen urinary excretion, aldosterone and renin activity in the blood plasma were monitored for a period of 72 hours. RESULTS: In any parameter of hemodynamic changes, no statistically significant difference was demonstrated between randomized groups, in particular measurements as well as in the development in the course of the first three days after the intervention. The result suggests similar efficacy of the circulatory dysfunction prevention after the paracentesis in both treatment procedures. In both groups, on the first three days, there was a tendency to improve hemodynamics reflected by the renin-angiotensin-aldosteron system activity. In the terlipressin group, this tendency approached statistically significant levels. CONCLUSIONS: The administration of terlipressin in a dose of 1 mg every fourth hour performed for a period of 48 hours was as effective as intravenous albumin in preventing hemodynamic changes in patients with tense ascites treated by paracentesis. The treatment was well tolerated.
RCT Entities:
BACKGROUND/AIMS: Postparacentesis circulatory dysfunction is the most severe complication of ascites paracentesis. The aim of our study was to compare the standard treatment with the administration of a vasoconstrictor terlipressin. METHODOLOGY: Forty-nine patients treated by paracentesis due to tense ascites were randomized for the treatment with albumin (8g/L of removed ascites) or terlipressin (1 mg every four hours for 48 hours). The blood pressure, heart rate, diuresis, electrocardiograph, standard biochemical and hematological parameters, sodium, potassium and nitrogen urinary excretion, aldosterone and renin activity in the blood plasma were monitored for a period of 72 hours. RESULTS: In any parameter of hemodynamic changes, no statistically significant difference was demonstrated between randomized groups, in particular measurements as well as in the development in the course of the first three days after the intervention. The result suggests similar efficacy of the circulatory dysfunction prevention after the paracentesis in both treatment procedures. In both groups, on the first three days, there was a tendency to improve hemodynamics reflected by the renin-angiotensin-aldosteron system activity. In the terlipressin group, this tendency approached statistically significant levels. CONCLUSIONS: The administration of terlipressin in a dose of 1 mg every fourth hour performed for a period of 48 hours was as effective as intravenous albumin in preventing hemodynamic changes in patients with tense ascites treated by paracentesis. The treatment was well tolerated.
Authors: Amine Benmassaoud; Suzanne C Freeman; Davide Roccarina; Maria Corina Plaz Torres; Alex J Sutton; Nicola J Cooper; Laura Iogna Prat; Maxine Cowlin; Elisabeth Jane Milne; Neil Hawkins; Brian R Davidson; Chavdar S Pavlov; Douglas Thorburn; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2020-01-16
Authors: Ki Tae Suk; Soon Koo Baik; Jung Hwan Yoon; Jae Youn Cheong; Yong Han Paik; Chang Hyeong Lee; Young Seok Kim; Jin Woo Lee; Dong Joon Kim; Sung Won Cho; Seong Gyu Hwang; Joo Hyun Sohn; Moon Young Kim; Young Bae Kim; Jae Geun Kim; Yong Kyun Cho; Moon Seok Choi; Hyung Joon Kim; Hyun Woong Lee; Seung Up Kim; Ja Kyung Kim; Jin Young Choi; Dae Won Jun; Won Young Tak; Byung Seok Lee; Byoung Kuk Jang; Woo Jin Chung; Hong Soo Kim; Jae Young Jang; Soung Won Jeong; Sang Gyune Kim; Oh Sang Kwon; Young Kul Jung; Won Hyeok Choe; June Sung Lee; In Hee Kim; Jae Jun Shim; Gab Jin Cheon; Si Hyun Bae; Yeon Seok Seo; Dae Hee Choi; Se Jin Jang Journal: Korean J Hepatol Date: 2012-03-22