Large-Volume Paracentesis: A Fast, Convenient, and Safe Technique

Banimahd, Faried; Spinello, Irene M.

doi:10.1016/j.jemermed.2008.09.022

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…However, our paracentesis complication rate was lower than previously reported rates that ranged from 0.9% to 1.6% [10][11][12]. Complications that have been previously described in relation to paracentesis procedures include severe pain, ascitic fluid leak, vasovagal events, hypotension, infection, bleeding, bowel perforation, liver/spleen puncture, and death [10].…”

Section: Discussioncontrasting

confidence: 59%

Wall suction-assisted image-guided therapeutic paracentesis: a safe and less expensive alternative to evacuated bottles

Kelil

Shyn

et al. 2016

Abdom Radiol

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Section: Discussioncontrasting

confidence: 59%

Wall suction-assisted image-guided therapeutic paracentesis: a safe and less expensive alternative to evacuated bottles

Kelil

Shyn

et al. 2016

Abdom Radiol

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“…Por lo tanto, las medidas iniciales se encaminan a mantener un balance negativo de sodio mediante la restricción de sal y el uso de diuréticos. 2,25 También es importante que en el paciente cirrótico con ascitis se trate la causa de base, 26 con el fin de disminuir la lesión del tejido hepático y mejorar la funcionalidad del órgano. Además es necesario evaluar, de acuerdo con el estado funcional del paciente, si es o no candidato para un trasplante hepático.…”

Section: Tratamientounclassified

Paracentesis evacuante en pacientes cirróticos con ascitis a tensión: revisión del tema

Enríquez

Gutiérrez

2010

Iatreia

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El desarrollo de ascitis es la complicación más frecuente del paciente con cirrosis hepática y generalmente marca el paso hacia la descompensación, con lo cual empeora el pronóstico y se deteriora la calidad de vida. Los estudios clínicos demuestran que aproximadamente el 50% de los pacientes cirróticos con ascitis no complicada mueren a los 2 años y que el 50% de los que desarrollan ascitis refractaria mueren a los 6 meses si no reciben tratamiento. Las medidas terapéuticas actuales en el paciente cirrótico con ascitis se encaminan a mantener un balance negativo de sodio, mediante la restricción del consumo de sal y el uso de diuréticos. Tales medidas pueden ser insuficientes en el caso de la ascitis a tensión, por lo que se requiere un tratamiento que mejore rápidamente la sintomatología y restaure la funcionalidad del paciente, además de medidas de soporte para prevenir la acumulación de líquido en la cavidad peritoneal y por ende reducir las enfermedades asociadas.Por lo anterior, la paracentesis evacuante seguida de fármacos diuréticos es el tratamiento de elección en los pacientes con ascitis a tensión.

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“…This method is thought to offer multiple benefits compared with the traditional glass vacuum bottle system, though these improvements have not previously been clearly defined. While a single study in the literature describes this method as 'fast, convenient, and safe', the complication profile of this method has also not been formally evaluated [Banimahd and Spinello, 2009]. There remains concern that rapid drainage of ascites as used in wall suction may increase the risk for paracentesis-induced circulatory dysfunction (PICD) with resultant renal injury, hemodynamic changes, and hyponatremia.…”

Section: Introductionmentioning

confidence: 99%

Randomized, controlled pilot study comparing large-volume paracentesis using wall suction and traditional glass vacuum bottle methods

Konerman

Price

Torres

et al. 2014

Therap Adv Gastroenterol

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Objectives: Large-volume paracentesis (LVP) can be time and labor intensive depending on the amount of ascites removed and the method of drainage. Wall suction has been adopted as the preferred method of drainage at many centers, though the safety and benefits of this technique have not been formally evaluated. The primary objective of this study was to define the cost and time savings of wall suction over the traditional glass vacuum bottle method for ascites drainage. The secondary objective was to compare the safety profile and patient satisfaction using these two techniques. Methods: We conducted a randomized, controlled pilot study of the wall suction versus vacuum bottle methods for LVP in hospitalized patients. All LVPs were performed under ultrasound guidance by a single proceduralist. Patients with at least 4 liters removed received 25% intravenous albumin, 8 g/liter fluid removed. Demographic, clinical characteristics, and procedure details were recorded. Laboratory and hemodynamic data were recorded for 24 h prior to and 24-48 h post LVP. An electronic chart review was conducted to evaluate procedure-related complications. Data were compared using Fisher's exact test, t test, or Mann-Whitney U test. Results: Thirty-four patients were randomized to wall suction at 200 mmHg (n = 17) or glass vacuum bottle drainage (n = 17). Wall suction was significantly faster and less costly than vacuum bottle drainage (7 versus 15 min, p = 0.002; $4.59 versus $12.73, p < 0.001). There were no differences in outcomes at 24 and 48 h post LVP, or at 60-day follow up. Conclusion: Performing LVP using wall suction resulted in significantly shorter procedure time and supply cost savings. There were no differences in outcomes between the groups, suggesting equivalent safety, though larger studies powered to detect small differences are needed. Given its efficiency, convenience, and cost effectiveness, wall suction may be a superior method of ascites drainage for LVP.

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Large-Volume Paracentesis: A Fast, Convenient, and Safe Technique

Cited by 4 publications

References 6 publications

Wall suction-assisted image-guided therapeutic paracentesis: a safe and less expensive alternative to evacuated bottles

Wall suction-assisted image-guided therapeutic paracentesis: a safe and less expensive alternative to evacuated bottles

Paracentesis evacuante en pacientes cirróticos con ascitis a tensión: revisión del tema

Randomized, controlled pilot study comparing large-volume paracentesis using wall suction and traditional glass vacuum bottle methods

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