Safety, complications and outcome of large volume paracentesis with or without albumin therapy in children with severe ascites due to liver disease

Sarma, Moinak Sen; Yachha, Surender Kumar; Bhatia, Vijayalakshmi; Srivastava, Anshu; Poddar, Ujjal

doi:10.1016/j.jhep.2015.06.019

Cited by 30 publications

(29 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These complications are mitigated by low-volume paracenteses and albumin replacement. Although a recent study by Sarma et al of 32 children in India with severe ascites noted no occurrence of acute kidney injury after largevolume paracentesis, data from the adult literature document rates of kidney injury after largevolume paracentesis to be as high as 20% (20). The ways in which paracentesis might precipitate renal injury in this setting are unknown, but postulated to be due to a renal vasoconstriction from cytokine stimulation of the sympathetic nervous system and activation of the renin-angiotensin-aldosterone pathway (21).…”

Section: Discussionmentioning

confidence: 93%

Safety of peritoneal and pleural drain placement in pediatric stem cell transplant recipients with severe veno‐occlusive disease

Madenci

Stetson

Weldon

et al. 2016

Pediatric Transplantation

View full text Add to dashboard Cite

Hepatic VOD (veno-occlusive disease) is a serious complication of HSCT (hematopoietic stem cell transplantation) and has historically been associated with high mortality. This obstruction to hepatic flow often results in fluid collections in the peritoneal and pleural cavities. Catheter placement to drain ascites or pleural fluid may reduce intra-abdominal hypertension and/or improve respiratory parameters. The safety of these interventions among critically ill, immunocompromised children is unknown. Among 32 HSCT recipients (2000-2012) with severe VOD, we assessed the primary outcome of procedural complication from peritoneal drain placement. Twenty-four (75%) patients underwent peritoneal drain placement. No patient sustained visceral perforation or hemorrhage with drain placement. Overall mortality was 47% (n = 15). The procedure was not associated with increased overall mortality (p > 0.99). Eight (25%) peritoneal drains required replacement for malfunction. Of 24 patients with peritoneal drains, one (4%) patient had a positive culture from ascitic fluid. Eight (25%) patients underwent pleural drain placement. No pleural drain-related procedural complication or infection occurred. Four (50%) of the eight patients with pleural drains had de-escalation in oxygen requirement at drain removal, compared to time of placement. In this study, peritoneal and pleural drains were safe interventions for children with severe VOD.

show abstract

Section: Discussionmentioning

confidence: 93%

Safety of peritoneal and pleural drain placement in pediatric stem cell transplant recipients with severe veno‐occlusive disease

Madenci

Stetson

Weldon

et al. 2016

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…In the other patients, who maintain a level of urinary excretion of sodium greater than 30 mEq/day, the diuretic treatment may be maintained in order to delay the reaccumulation of the ascites and thereby also the need for periodic evacuation paracentesis to be performed so often [6,7].…”

Section: Periodic Evacuation Paracentesismentioning

confidence: 99%

Introductory Chapter: Treatment of Ascites Associated with Cirrhosis and Its Complications

Rodrigo¹

2017

Ascites - Physiopathology, Treatment, Complications and Prognosis

View full text Add to dashboard Cite

“…45,84 A recent observational study in children with these characteristics showed similar results. 59 There is consensus that albumin infusion plays a significant role in HRS management. 5,6,8,9,76 For this reason, it is also recommended in these situations.…”

Section: Therapeutic Options Albumin Prescriptionmentioning

confidence: 99%

Management of cirrhotic ascites in children. Review and recommendations. Part 2: Electrolyte disturbances, nonelectrolyte disturbances, therapeutic options

et al. 2017

View full text Add to dashboard Cite

Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of a pediatric patient with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care.

show abstract

Safety, complications and outcome of large volume paracentesis with or without albumin therapy in children with severe ascites due to liver disease

Cited by 30 publications

References 26 publications

Safety of peritoneal and pleural drain placement in pediatric stem cell transplant recipients with severe veno‐occlusive disease

Safety of peritoneal and pleural drain placement in pediatric stem cell transplant recipients with severe veno‐occlusive disease

Introductory Chapter: Treatment of Ascites Associated with Cirrhosis and Its Complications

Management of cirrhotic ascites in children. Review and recommendations. Part 2: Electrolyte disturbances, nonelectrolyte disturbances, therapeutic options

Contact Info

Product

Resources

About