| Clinical Trial: High-dose furosemide plus small-volume hypertonic saline solutions vs. repeated paracentesis as treatment of refractory ascites. | |
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MedLine Citation:
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PMID: 19438847 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In patients with cirrhosis, ascites is defined as refractory when it cannot be mobilized or recurs early in standard diuretic therapy. AIM: To compare the safety and efficacy of intravenous high-dose furosemide + hypertonic saline solutions (HSS) with repeated paracentesis in patients with cirrhosis and refractory ascites. PATIENTS AND METHODS: Eighty-four subjects (59/25 M/F) with cirrhosis, mostly of viral aetiology, admitted for refractory ascites, were randomly assigned to receive furosemide (250-1000 mg/bid i.v.) plus HSS (150 mL H(2)O with NaCl 1.4-4.6% or 239-187 mEq/L) (60 patients, Group A) or to repeated paracentesis and a standard diuretic schedule (24 patients, Group B). RESULTS: During hospitalization, Group A patients had more diuresis (1605 +/- 131 mL vs. 532 +/- 124 mL than Group B patients; P < 0.001) and a greater loss of weight at discharge (-8.8 +/- 4.8 kg vs. -4.5 +/- 3.8 kg, P < 0.00). Control of ascites, pleural effusions and/or leg oedema was deemed significantly better in Group A. CONCLUSIONS: This randomized pilot study suggests that HHS plus high-dose furosemide is a safe and effective alternative to repeated paracentesis when treating hospitalized patients with cirrhosis and refractory ascites. Larger studies will be needed to evaluate long-term outcomes such as readmission and mortality. |
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Authors:
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G Licata; A Tuttolomondo; A Licata; G Parrinello; D Di Raimondo; R Di Sciacca; C Camm?; A Crax?; S Paterna; A Pinto |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial Date: 2009-05-12 |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 30 ISSN: 1365-2036 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-23 Completed Date: 2010-02-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: England |
Other Details:
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Languages: eng Pagination: 227-35 Citation Subset: IM |
Affiliation:
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Unit? Operativa di Medicina Interna e Cardio-Angiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Ascites / etiology, therapy* Diuretics / therapeutic use* Dose-Response Relationship, Drug Female Furosemide / administration & dosage* Humans Liver Cirrhosis / complications, physiopathology, therapy* Male Middle Aged Paracentesis* Pilot Projects Saline Solution, Hypertonic / administration & dosage* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Diuretics; 0/Saline Solution, Hypertonic; 54-31-9/Furosemide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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