Document Detail


Clinical Trial: High-dose furosemide plus small-volume hypertonic saline solutions vs. repeated paracentesis as treatment of refractory ascites.
MedLine Citation:
PMID:  19438847     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-05-12
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  30     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-23     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  227-35     Citation Subset:  IM    
Affiliation:
Unit? Operativa di Medicina Interna e Cardio-Angiologia, Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy.
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MeSH Terms
Descriptor/Qualifier:
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:
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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