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At least 217 records · Page 12Linked to original sources
PubMed1993

Total therapeutic paracentesis (TTP) with and without intravenous albumin in the treatment of cirrhotic tense ascites: a randomized controlled trial.

We studied 35 cirrhotic patients with tense ascites assigned at random into two groups: Group I consisted of 17 patients treated by total therapeutic paracentesis (TTP) (6-15 l) plus i.v. albumin (5 g/l of fluid) and Group II consisted of 18 patients treated by TTP (5.5-15.5 l) without albumin. On 19 patients we performed a sequential assessment of cardiac output (CO), plasma renin activity (PRA) and plasma aldosterone (PA). Both groups were similar in age, sex, and etiology of cirrhosis. CO, PRA and PA values were expressed as mean changes occurring in relation to their respective baseline values. CO changes after TTP (l/min): Group I: 2.5 after 6 h and 2.2 after 12 h; Group II: 2.2 after 6 h and -0.4 after 12 h, (p < 0.05 comparing values after 12 h between the two groups). PRA changes after TTP (ng/dl/h): Group I: -7.4 after 1 h, -7.8 after 6 h and -3.2 after 24 h; Group II: -2.4 after 1 h, -0.8 after 6 h and 3.9 after 24 h (p < 0.05 comparing values between both groups after 6 and 24 h). PA changes after TTP (ng/dl): Group I: -50.5 after 1 h, -36.7 after 6 h and -34.6 after 24 h; Group II: -18.2 after 1 h, -2.2 after 6 h and 20 after 24 h, (p < 0.05 comparing values between both groups after 1 and 6 h). Complications were minimal in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Sonographically guided paracentesis for palliation of symptomatic malignant ascites.

The technique, results, and complications of 109 consecutive sonographically guided therapeutic paracenteses performed on 43 patients with malignant ascites are summarized. A 5.5-French Sacks One-Step Catheter was used in all cases but five in which tissue resistance prohibited passage of the catheter through the abdominal wall. The procedure was performed on an inpatient basis 70 times and in an outpatient setting 39 times. Colonic, ovarian, and breast carcinomas accounted for over 50% of the tumors resulting in malignant fluid collections. Three complications (hypotension, 2.6%) were directly related to the procedure; two of them were fatal (1.6%). The amount of ascitic fluid drained within the first 24 hr averaged 3.5 l at rates of 100-150 ml/sec. Ninety-five procedures (87%, in 39 patients) resulted in improvement of symptoms after drainage as manifested by decreased pain from abdominal distention, alleviation of nausea, improved appetite, or decreased dyspnea. The duration of symptomatic relief ranged from 4 days to 45 days (mean, 10.4 days). Sonographically guided paracentesis is an effective procedure that can be performed for short-term relief of symptoms caused by malignant ascites.

Adult↗
PubMed1980

Tympanometry in three-year-old children. III. Correlation between tympanometry and findings at paracentesis in a prospectively followed population of otherwise healthy children aged 3--4 years.

Paracentesis was performed on 46 three- to four-year-old children out of all 523 three-year-olds in a geographically defined area, because these 46 children had persistently showed abnormal tympanograms over a 6-month period. The findings were correlated to the parameters middle ear pressure, absolute compliance, absolute gradient, and relative gradient. As regards the state of effusion in the middle ear, all these parameters--except for the middle ear pressure--showed a high predictive value. The significance of the findings in the tympanometric diagnosis of middle ear disease in the younger age groups is outlined.

Acoustic Impedance Tests↗
PubMed1991

An aqueous paracentesis pipet.

We describe a glass pipet tipped with a short, sharp, 30-gauge needle for performing aqueous paracentesis. The design eliminates the possibility of needle bending and minimizes fractional resistance during limbus penetration; it also allows quicker recovery of aqueous samples. A small plastic bulb at the upper end facilitates removal of aqueous samples from the pipet.

Aqueous Humor↗
PubMedDate not supplied

[Therapeutic paracentesis with albumin infusion for the treatment of tension ascites in cirrhotic patients. Preliminary report].

UNLABELLED: It has been recently reported that repeated large volume paracentesis (LVP) is a safe and efficacious procedure to treat cirrhotics with tense ascitis. In this paper we present the results of our experience with the use of this method. We studied 10 cirrhotics with tense ascites. The criteria for exclusion are described in the text. During LVP, iv albumin infusion was given (25 g each tap). Patients were followed during 3-4 months after discharge from the hospital. RESULTS: Eighteen LVP were made in 10 patients. The mean age was 56 years (range 37-77). Six had peripheral edema. The mean volume of ascitic removed was 6.75 L (range 5-12) per tap. No clinic or hemodynamic complications were observed. With exception of serum cholesterol, which showed a decrease after LVP, laboratory tests did not show any significant modification. Two patients died 3 and 6 weeks after LVP due to hepatic failure and digestive hemorrhage. The procedure was well tolerated. Two were readmitted to the hospital after three months because of ascites. We conclude that LVP plus 25 g of i.v. albumin infusion is a safe and efficacious method to treat cirrhotic tense ascites. After three months no renal function impairment was observed. LVP decrease serum cholesterol.

Adult↗
PubMed1990

[Morphological study of the disruption of the blood-aqueous barrier following paracentesis].

Long-term morphological changes of the blood-aqueous barrier following paracentesis were studied in monkeys. Horseradish peroxidase molecules given intravenously were detected in the intercellular space beyond the tight junction between the nonpigmented ciliary epithelial cells in a monkey 7 days after the operation. The data demonstrated that the breakdown of the blood-aqueous barrier was not functionally repaired 7 days after the operation. Cysts were observed at the most anterior portions of the ciliary processes in monkeys surviving for 14 days to 1 year. These cysts consisted of two layers of both pigmented and nonpigmented epithelial cells. These findings suggest that the breakdown of the blood-aqueous barrier remains not to be repaired for log periods.

Animals↗
PubMed1989

[Exploration, diagnosis and treatment of eustachian tube diseases by means of positive pressure through a tympanic membrane perforation, or by paracentesis and transtympanic drainage].

The A. discuss a manoeuvre seldom done in otology, consisting in the forced passage of air through the external canal and through perforations in the drum (also through paracentesis with an inserted ventilation tube) in those cases of otitis sharing tubal pathology. Medicines in solution or given by aerosol therapy led sometimes to surprising outcomes when dealing with chronic stubborn middle ear infections withstanding conventional treatments. Besides, the flow of air, as well as radio-opaque drugs, introduced this way, aid both the examination and the inventory of the actual state of the tube prior to functional operations on the ear. The paper recalls the danger of repeated topical administration of ear drops (as once was the usual mode of management) with alcohol or formol solutions, so endangering irreversibly the mucous membrane of the cavum tympani, with the subsequent difficulties. Finally, the A. report on the salpingitis accompanying the dyscrasias of the respiratory tract in relation to the reflex zone of the nasopharynx.

Chronic Disease↗
PubMed1985

A twenty-four year retrospective study of dependent catheter paracentesis.

Dependent catheter paracentesis has been used on 590 patients over the last 24 years. The complication rate is zero. It is faster, as accurate, cheaper and less hypersensitive than diagnostic peritoneal lavage. Open, semi-open and closed diagnostic peritoneal lavage when used with trocars is unjustified because of a significant complication rate.

Catheterization↗
PubMed1979

Abdominal paracentesis for malignant ascites.

Abdominal paracentesis for malignant ascites may be performed safely for several hours by insertion of a plastic tube through an intracatheter needle. The system is closed and sterile for up to 9 liters of drainage.

Abdomen↗
PubMed1993

Paracentesis. The importance of optimal ascitic fluid analysis.

An accumulation of peritoneal fluid can result from a variety of conditions, cirrhosis of the liver being responsible for about 75% of all patients with ascites. Malignancy accounts for 10-12% and cardiac failure for about 5%. The remaining 8-10% of ascites cases have a variety of causes, including tuberculosis, pancreatic disease and kidney disease. An early and accurate diagnosis often depends on an appropriate ascitic fluid analysis. Patients with known liver cirrhosis and clinical deterioration also need to have a paracentesis, with a determination of the ascitic fluid leukocyte and neutrophil count and adequate bacteriological cultures of their ascitic fluid. The diagnostic value of different ascitic fluid parameters and their ability to distinguish between several aetiologies and their complications, is discussed.

Ascites↗
PubMed1977

Penetrating torso injuries: the role of paracentesis and lavage.

Controversy still exists regarding the proper approach to patients with penetrating torso injuries. Mandatory immediate celiotomy and selective observation both have associated risks. Paracentesis with lavage is a rapid, easily performed and readily available technique which can, with a high degree of accuracy, differentiate on initial evaluation those patients with penetrating visceral injuries from those without such injuries. Complications are minimal. The use of these two procedures in evaluating penetrating torso injuries has led to improved patient care and produced major lowering of medical and socioeconomic costs.

Abdominal Injuries↗
PubMed1993

Pulmonary function changes after large volume paracentesis.

Large volume paracentesis (LVP) is a safe, rapid, and effective treatment of ascites in cirrhotic patients. We investigated the effects of a 5-L aspiration of ascites on pulmonary function parameters in eight hemodynamically stable patients with cirrhosis and tense ascites. None had known lung disease or abnormal chest roentgenograms. At baseline, mean lung volumes, diffusing capacity, and arterial pO2 were all reduced from normal predicted values. Airflow, however, when related to lung volume, was normal. Post-LVP, lung volumes increased significantly; the mean expiratory reserve volume showed the greatest percent increase (105%) and correlated with the increases in the vital capacity, functional residual capacity, and total lung capacity. Airflow, the mean diffusing capacity, and arterial oxygenation were not significantly changed after LVP. We conclude that LVP significantly increases indices of lung volume but does not significantly alter parameters of airflow or gas exchange.

Ascites↗
PubMed1977

The ascitic leak: a case presentation. Management by paracentesis and saline--albumin reinfusion.

Postoperative ascites, particularly if infected, poses a difficult clinical situation for the surgeon. Concomitant use of salt and water restriction and diuretics will control most cases. However, in those patients who do not respond, paracentesis with a peritoneal dialysis cathether together with concomitant infusions, cubic centimeter for cubic centimeter, of saline-albumin or fresh frozen plasma will insure a sufficient intravascular volume to enable adequate renal perfusion, decrease intra-abdominal pressure to allow adequate respiratory mechanics, and decrease potential losses from around drainage tubes. Thus the cirrhotic patient may recover more easily from the insult of the nonhepatic surgical procedure. A case is presented demonstrating this technique.

Albumins↗