Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/51956
Título: Comparison of paracentesis and diuretics in the treatment of cirrhotics with tense ascites. Results of a randomized study
Autores/as: Ginés, Pere
Arroyo, Vicente
Quintero, Enrique
Planas, Ramón
Bory, Felipe
Cabrera, Juan 
Rimola, Antoni
Viver, Josep
Camps, Jordi
Jiménez, Wladimiro
Mastai, Ricardo
Gaya, Joan
Rodés, Joan
Clasificación UNESCO: 32 Ciencias médicas
320503 Gastroenterología
Palabras clave: Paracentesis
Diuretics
Cirrhotic
Ascites
Fecha de publicación: 1987
Publicación seriada: Gastroenterology 
Resumen: To investigate whether paracentesis could be an alternative therapy for ascites, 117 cirrhotics with tense ascites were randomly allocated into two groups. Fifty-eight patients (group 1) were treated with paracentesis (4–6 L/day until disappearance of ascites) and intravenous albumin infusion (40 g after each tap). Fifty-nine patients (group 2) were treated with spironolactone (200–400 mg/day) plus furosemide (40–240 mg/day). Patients from group 2 not responding to diuretics were treated with a LeVeen shunt. After disappearance of ascites, patients from both groups were discharged from hospital and were instructed to take diuretics. Patients developing tense ascites during follow-up were readmitted to hospital and treated according to their initial schedule. Paracentesis was effective in eliminating the ascites in 56 patients from group 1 (96.5%) and did not induce significant changes in renal and hepatic function, plasma volume, cardiac index, peripheral resistance, plasma renin activity, plasma norepinephrine and antidiuretic hormone concentration, and urinary excretion of prostaglandin E2 and 6-keto-prostaglandin F1α. Diuretics were effective in eliminating the ascites in 43 patients from group 2 (72.8%) (p < 0.05). Ten patients in group 1 and 36 in group 2 developed complications during their first hospital stay (p < 0.001). This difference was due to the significantly higher incidence of hepatic encephalopathy, renal impairment, and electrolyte disturbances occurring in patients treated with diuretics. The duration of hospital stay was 11.7 ± 1.5 days for patients from group 1 and 31 ± 2.8 days for patients from group 2 (p < 0.001). The two groups did not differ significantly with respect to the probability of requiring readmission to hospital during follow-up, reasons for readmission, survival probability after entry into the study, and causes of death. These results indicate that paracentesis associated with intravenous albumin infusion is a fast, effective, and safe therapy for ascites in patients with cirrhosis.
URI: http://hdl.handle.net/10553/51956
ISSN: 0016-5085
DOI: 10.1016/0016-5085(87)91007-9
Fuente: Gastroenterology[ISSN 0016-5085],v. 93(2), p. 234-241 (Agosto 1987)
Colección:Artículos
Vista completa

Citas SCOPUSTM   

461
actualizado el 24-mar-2024

Visitas

69
actualizado el 23-mar-2024

Google ScholarTM

Verifica

Altmetric


Comparte



Exporta metadatos



Los elementos en ULPGC accedaCRIS están protegidos por derechos de autor con todos los derechos reservados, a menos que se indique lo contrario.