| Beta-blockers cause paracentesis-induced circulatory dysfunction in patients with cirrhosis and refractory ascites: a cross-over study. | |
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MedLine Citation:
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PMID: 21354230 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: In patients with cirrhosis and refractory ascites the role of beta-blockers in the development of paracentesis-induced circulatory dysfunction (PICD) is unknown. The aim of this study was to investigate the incidence of PICD before and after discontinuation of beta-blockers in patients with cirrhosis and refractory ascites. A self control cross-over study was performed. METHODS: Patients with cirrhosis and refractory ascites treated with beta-blockers were selected. Heart rate, arterial pressure, and plasma renin concentrations (PRC) were collected before, immediately after and 1 week after large-volume paracentesis associated with intravenous albumin administration. Beta-blocker therapy was progressively discontinued after complete endoscopic eradication of varices. The clinical and biological evaluation was then repeated. The presence of PICD was defined as an increase in PRC of at least 50% above baseline 1 week after paracentesis. RESULTS: Ten patients were included (nine men, mean age 59.1 ± 10.7 years old). The MELD score was 17.7 ± 4.4 and eight patients were Child-Pugh C. When patients were given beta-blockers, the heart rate did not change immediately after paracentesis while mean arterial pressure significantly decreased; PICD developed in eight patients. After beta-blockers were discontinued, the heart rate significantly increased immediately after paracentesis and mean arterial pressure significantly decreased; PICD only developed in one patient; the difference in the incidence of PICD was significant when these same patients were treated with beta-blockers. CONCLUSIONS: The use of beta-blockers may be associated with a high risk of PICD in patients with cirrhosis and refractory ascites. |
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Authors:
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Thomas Sersté; Claire Francoz; François Durand; Pierre-Emmanuel Rautou; Christian Melot; Dominique Valla; Richard Moreau; Didier Lebrec |
Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2011-02-24 |
Journal Detail:
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Title: Journal of hepatology Volume: 55 ISSN: 0168-8278 ISO Abbreviation: J. Hepatol. Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-09-19 Completed Date: 2011-11-21 Revised Date: 2012-01-25 |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 794-9 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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INSERM, U773, Centre de Recherche Biomédicale Bichat Beaujon CRB3 Clichy, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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administration & dosage,
adverse effects* Aged Ascites / physiopathology, therapy* Blood Pressure / drug effects, physiology Cardiovascular Diseases / chemically induced*, physiopathology Combined Modality Therapy Creatinine / blood Cross-Over Studies Female Follow-Up Studies Heart Rate / drug effects, physiology Humans Liver Cirrhosis / drug therapy*, physiopathology Male Middle Aged Paracentesis / adverse effects* Propranolol / administration & dosage, adverse effects* Renin / blood Sodium / blood Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 525-66-6/Propranolol; 60-27-5/Creatinine; 7440-23-5/Sodium; EC 3.4.23.15/Renin |
| Comments/Corrections | |
Comment In:
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J Hepatol. 2011 Oct;55(4):743-4
[PMID:
21396970
]
J Hepatol. 2012 Jan;56(1):298-9 [PMID: 22173037 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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