Document Detail


Time course of circulatory and humoral effects of rapid total paracentesis in cirrhotic patients with tense, refractory ascites.
MedLine Citation:
PMID:  8119542     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Tense ascites of cirrhosis can be treated with total paracentesis; however, the short-term effects of this procedure are poorly defined. METHODS: The circulatory and humoral changes induced by total paracentesis (250 mL/min) were studied in 12 cirrhotics with tense, refractory ascites. Data were collected before, during, and after paracentesis and 24 hours later (after albumin infusion). Hormonal parameters were recorded again 48 hours and 6 days thereafter. RESULTS: Paracentesis (10.7 +/- 4.4 L; 64 +/- 20 minutes) caused marked reduction of intra-abdominal, intrathoracic, right atrial, and pulmonary pressures. Heart rate did not change. Cardiac output and heart volumes increased. Systemic vascular resistances and mean arterial pressure slightly decreased. Baseline plasma renin and aldosterone levels were markedly increased; a reduction was already evident during paracentesis with the lowest values at the end of the procedure. All changes were maintained 24 hours later. Hormones regained baseline levels 6 days later. CONCLUSIONS: Rapid total paracentesis is accompanied by marked cardiovascular and humoral changes. Some of these changes can be explained by mechanical factors that are directly or indirectly related to the relief of abdominal pressure. However, other changes (systemic vasodilatation, humoral deactivation) have a non-mechanical nature and may depend on reflexes originating from cardiac volume receptor stimulation. Most changes may beneficially (albeit transiently) influence the cardiovascular system of cirrhotic patients with tense ascites.
Authors:
M Pozzi; G Osculati; G Boari; P Serboli; P Colombo; C Lambrughi; S De Ceglia; L Roffi; A Piperno; E N Cusa
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastroenterology     Volume:  106     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-04-01     Completed Date:  1994-04-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  709-19     Citation Subset:  AIM; IM    
Affiliation:
Cattedra di Medicina Interna, Università degli Studi di Milano, Italy.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery*
Adult
Aged
Aldosterone / blood
Ascites / etiology*,  physiopathology,  surgery*
Atrial Natriuretic Factor / blood
Blood Circulation*
Echocardiography
Female
Hemodynamics
Humans
Liver Cirrhosis / complications*
Male
Middle Aged
Punctures*
Renin / blood
Time Factors
Chemical
Reg. No./Substance:
52-39-1/Aldosterone; 85637-73-6/Atrial Natriuretic Factor; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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