Document Detail

Large-volume paracentesis in the management of ascites in children.
MedLine Citation:
PMID:  11593116     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Large-volume paracentesis has been evaluated for both therapeutic and diagnostic purposes in the management of ascites in cirrhotic adults. There are no published data relating to the safety, efficacy, or methods of this procedure in children. The objective of this study was to characterize the authors' initial experience with large-volume paracentesis (> 50 ml/kg of ascites) for removal of tense abdominal ascites in the pediatric population. METHODS: Retrospective chart review was performed of 21 large-volume paracentesis sessions in seven children (ages 6 months-18 years) with tense ascites that did not respond to other measures. RESULTS: Mean volume removed was 3,129 +/- 2,966 ml (mean +/- standard deviation) or 118 +/- 56 ml/kg over 2.9 +/- 3.7 hours by a 16-gauge intravascular catheter in 6 sessions, by an 18-gauge intravascular catheter in three sessions, and by a 15-gauge fenestrated, stainless-steel paracentesis needle in 12 sessions. Large-volume paracenteses performed with the paracentesis needle had significantly shorter duration of drainage and faster flow rates than those performed with the intravascular catheter. The only complication encountered was decreased urine output in one session. CONCLUSIONS: Large-volume paracentesis is a safe and effective therapeutic method for managing tense abdominal ascites in children. The use of the paracentesis needle significantly improved the speed and efficiency of large-volume paracentesis compared with the intravascular catheter.
R E Kramer; R J Sokol; B Yerushalmi; E Liu; T MacKenzie; E J Hoffenberg; M R Narkewicz
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  33     ISSN:  0277-2116     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-10-10     Completed Date:  2002-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-9     Citation Subset:  IM    
Pediatric Liver Center and Liver Transplantation Program, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children's Hospital and University of Colorado Health Sciences Center, Denver, Colorado 80218, USA.
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MeSH Terms
Ascites / therapy*
Child, Preschool
Liver Cirrhosis / complications*,  physiopathology
Paracentesis / adverse effects,  methods*
Plasma Volume / physiology
Retrospective Studies
Treatment Outcome
Comment In:
J Pediatr Gastroenterol Nutr. 2003 Aug;37(2):207-8   [PMID:  12883313 ]

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