Document Detail


Respiratory impact of paracentesis in cirrhotic patients with acute lung injury.
MedLine Citation:
PMID:  21036523     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Ascites may contribute to the loss of lung volume and alter the gas exchange in cirrhotic patients with acute lung injury (ALI).
AIM: The aim of the study was to evaluate the effects of paracentesis on respiratory parameters in ventilated cirrhotic patients with ALI.
STUDY DESIGN: This was a prospective trial in an intensive care unit of a university hospital.
PATIENTS AND METHODS: Thirty-one cirrhotic patients on mechanical ventilation (with ALI) requiring paracentesis were included in this study. Arterial blood gases, intraabdominal pressures, ventilator parameters, and lung volumes were measured before and after the ascitic drainage.
RESULTS: Following paracentesis, the intraabdominal pressure decreased (24.1 ± 7.0 vs 12.3 ± 8.9 mm Hg, P < .0001) and the Pao(2)/Fio(2) improved significantly (190.0 ± 65.2 vs 284.9 ± 76.1 mm Hg, P < .0001), without hemodynamic disturbances. End-expiratory lung volume, markedly reduced before drainage, increased significantly following paracentesis (Δ end-expiratory lung volume: +463 ± 249 mL, P = .0009). No adverse effects related to the paracentesis were encountered.
CONCLUSION: In contrast to ventilatory recruitment maneuvers, paracentesis is a simple and well-tolerated technique able to improve oxygenation and alveolar recruitment without the risk of the lung overdistension in severely hypoxemic cirrhotic patients.
Authors:
Eric Levesque; Emir Hoti; Jin Jiabin; Jean Dellamonica; Philippe Ichai; Faouzi Saliba; Daniel Azoulay; Didier Samuel
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Publication Detail:
Type:  Journal Article     Date:  2010-10-30
Journal Detail:
Title:  Journal of critical care     Volume:  26     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  257-61     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France.
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