The Role of Intravenous Albumin Replacement During Abdominal Paracentesis in Patients With Malignancy Related Ascites

Launched by NATIONAL UNIVERSITY HOSPITAL, SINGAPORE · Jun 21, 2016

Keywords

ClinConnect Summary

General Introduction:

Therapeutic paracentesis is the first line of treatment for patients with symptomatic malignant ascites. The practice of intravenous albumin infusion during abdominal paracentesis comes from evidence in patients with liver cirrhosis. A meta-analysis of seventeen randomised trials evaluating patients receiving albumin versus alternative treatment during large volume paracentesis found that albumin reduced the incidence of post-paracentesis circulatory dysfunction, hyponatraemia and mortality (Bernardi M, 2012). The mechanisms of ascites in patients with cirrhosis are d...

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Eligibility criteria

• Inclusion Criteria:
• • Age more than 21 years old
• • Inpatients admitted to medical oncology service with symptomatic ascites and who are scheduled for abdominal paracentesis
• • Known underlying malignancy
• • Blood pressure before abdominal paracentesis more than 90/50 mmHg
• Exclusion Criteria:
• • Patients with known portal hypertension, defined by serum albumin: ascites gradient (SAAG) more than 11.1 mmol/L, based on previous results in last 1 year
• • Patients with a known history of hypotension when getting paracentesis
• • Pregnant women