SEARCH · Search PubMed

Results for “Paracentesis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

PubMed1986

Effect of flunixin meglumine on the breakdown of the blood-aqueous barrier following paracentesis in the canine eye.

The protein and PGE2 metabolite content of the aqueous humor from untreated and flunixin meglumine pretreated dogs was determined prior to and after anterior chamber paracentesis. In the untreated dogs the concentrations of protein and PGE2 metabolite in aqueous humor were greatly elevated secondary to paracentesis. Intravenously administered flunixin meglumine (1.1 mg/kg or 2.2 mg/kg) significantly reduced these inflammatory parameters, confirming that prostaglandins are involved in the stability of the blood-aqueous barrier by paracentesis in the canine eye. The clinical implication of these results is that intravenous administration of flunixin meglumine before intraocular surgery should be considered as an adjunct therapy to reduce intraoperative and postoperative uveitis.

Animals↗

PubMed1978

Effect of paracentesis on ocular cloxacillin concentration.

The effect of anterior chamber puncture on cloxacillin concentration in the rabbit eye after intravenous injection was studied using a radioactive tracer method. The enhancement in drug concentration caused by paracentesis was most immediate and significant in the iris-ciliary body preparation. It was soon followed by high cloxacillin concentration in the aqueous humour, which contributed to elevated cloxacillin levels in the cornea, lens and anterior vitreous body, when compared to normal material. Contrary to normal eyes, cloxacillin concentration in the cornea of the punctured eyes was higher than in the limbal area. The morphological changes occurring after paracentesis are discussed. The breakdown of the hydrodynamic equilibrium in the eye, suggested as the only change after paracentesis by Raviola (1974), cannot merely explain the cloxacillin concentration changes measured in the punctured eye.

Animals↗

PubMed1992

New needle for paracentesis.

An important complication of paracentesis with disposable needles is injury to the lens being caused by the intraocular part of the needle. The new needle has a locking mechanism which prevents its penetrating too deeply into the eye and thus reduces the danger of lens injury. The tip of the needle has been extended in the shape of a lance to reduce the pressure during the puncture of the cornea and to avoid the Seidel phenomenon. The needle can be combined with a tuberculin syringe or pipette. It is superior to disposable needles, particularly in situations in which unexpected movements must be taken into account, i.e. during paracentesis in children, paracentesis where assistants are involved or during cumbersome manipulations.

Animals↗

PubMed1976

Abdominal paracentesis in the diagnosis of ruptured ectopic pregnancy.

A prospective study of the use of abdominal paracentesis in the diagnosis of suspected ectopic pregnancy was carried out. Paracentesis was performed in 189 patients, of whom 132 were subsequently shown to have ectopic pregnancies. Paracentesis confirmed the diagnosis in 90,9% of cases, but when this was corrected to exclude cases where no intraperitoneal haemorrhage was present, the success rate rose to 96,3%. We believe that this simple, harmless, bedside procedure has value in aiding and confirming the diagnosis of ruptured ectopic pregnancy.

Abdomen↗

PubMed1991

Randomized comparative study of hemaccel vs. albumin infusion after total paracentesis in cirrhotic patients with refractory ascites.

Fifty-four cirrhotic patients with refractory ascites were treated with one-session large-volume paracentesis and randomly assigned to two groups. The first group was infused with human albumin, and the second group was infused with hemaccel at doses with comparable oncotic power. The two groups were compared for incidence of complications, recurrence of massive ascites after hospital dismissal and survival rate. The incidence of complications traditionally related to paracentesis, the probability of requiring readmission to the hospital for ascites (p = 0.48) and the probability of survival after entry into the study (p = 0.85) were the same for the two groups. A multivariate analysis of 16 parameters, including treatment modality, identified absolute unresponsiveness to diuretics as the only independent predictor of mortality. These results indicate that hemaccel infusion may safely replace albumin infusion after total paracentesis for cirrhotic patients with refractory ascites.

Aldosterone↗

PubMed1991

Large-volume paracentesis and intravenous saline: effects on the renin-angiotensin system.

Fourteen cirrhotic patients with tense ascites were treated with total paracentesis and intravenous isotonic saline infusion. Standard liver and kidney function tests, plasma renin activity and aldosterone concentration were measured before, at 48 hrs and at 7 days after total paracentesis. The volume of ascites removed was 7.7 +/- 5.6 l (mean +/- S.E.M.). None of the treated patients had clinical complications or significant alterations in liver or kidney function test results. Paracentesis and intravenous isotonic saline infusion were not associated with significant changes in mean plasma renin activity or plasma aldosterone concentration. These results suggest that this therapeutic procedure could be a safe and cost-effective alternative treatment of tense ascites in patients with cirrhosis.

Aged↗

PubMed1990

[Paracentesis combined with albumin infusion in the treatment of tense ascites in cirrhotic patients].

We randomized 31 cirrhotic patients with tense ascites to a Group A receiving only diuretic therapy (spironolactone, furosemide, n = 14) or a Group B treated with paracentesis and intravenous albumin infusion (n = 17). Ascites was eliminated in 88% of patients in Group B compared to 57% of patients in Group A (p < 0.05). Complications developed in 4 patients in Group A and 2 patients in Group B. Paracentesis was associated to a mild and transient reduction in mean arterial pressure and a significant rise in urinary output. Duration of hospital stay was 5 +/- 3 days in Group B and 22 +/- 6 in Group A (p < 0.001). Survival and likelihood of readmission for ascites was similar in both groups. Our results suggest that paracentesis plus intravenous albumin infusion is a fast, safe and effective therapy for tense ascites in cirrhotic patients.

Albumins↗

PubMed1990

Renaissance of paracentesis in the treatment of ascites.

The dangers of large-volume paracentesis have been overemphasized in the past. Recent data fail to show hypovolemia or any other complications ascribable to 5-L paracentesis when it is accompanied by IV infusion of 40 gm of albumin. Other data question the need for albumin infusion. Large-volume paracentesis is now a therapeutic option for relief of symptomatic, tense ascites, and, in company with sodium restriction, for chronic management of ascites refractory to diuretics.

Ascites↗

PubMed1986

Paracentesis of ascitic fluid. A safe procedure.

A prospective study of 229 abdominal paracenteses performed on 125 patients with ascites revealed only two major complications (transfusion-requiring abdominal wall hematomas) in a single patient (0.9% of paracenteses and 0.8% of patients), and two minor complications (non-transfusion-requiring hematomas) in two patients (0.9% of paracenteses and 1.6% of patients). No paracentesis resulted in bacterial peritonitis or death. Abdominal paracentesis in patients with ascites is a safe procedure. Fear of complications of the procedure should not preclude performing a paracentesis, provided certain precautions are taken.

Abdominal Muscles↗

PubMed1986

Ascites: ultrasound guidance or blind paracentesis?

The classic site for paracentesis in generalized ascites is in the left lower quadrant of the abdomen at a position equivalent to McBurney's point. Its use has an average success rate of 58%, depending on the amount of liquid. To assess the efficacy of paracentesis at this site and to establish the ideal site for blind puncture, we studied 27 consecutive patients with ascites detected by abdominal ultrasonography. The amount of ascites was graded from 1 to 4. Free fluid had accumulated mostly in the perihepatic region, then around the bladder and in the right paracolic gutter, and finally in the left flank. In six of the eight patients in whom fluid was found in the left or right flank, air-filled bowel loops were observed between the abdominal wall and the fluid, in the expected path of a blind puncture. These findings suggest that the safety and efficacy of paracentesis would be greatly improved by ultrasonographic guidance.

Adult↗

PubMed1980

Insulin concentrations in aqueous humor after paracentesis and feeding of rabbits.

Although the lens has been shown to have the capacity to respond to insulin in vitro, little is known concerning the biochemical relationships of insulin to the lens in vivo. Therefore we have measured insulin in the aqueous humor of rabbits by a sensitive radioimmunoassay after paracentesis and feeding. The insulin concentration in aqueous humor was 3% of that in plasma. One hour after paracentesis the aqueous humor insulin concentration was increased sixfold, apparently due to breakdown of the blood-aqueous barrier, but 1 week after paracentesis it had returned to its original level, apparently because of restoration of the blood-aqueous barrier within that time. After feeding, the aqueous humor insulin concentration was increased by 30% compared to a 175% increase in plasma. Factors influencing the aqueous humor insulin concentration and the possibility of insulin influence on lens metabolism are discussed.

Animals↗

PubMedDate not supplied

[Massive paracentesis and administration of dextran 70 vs albumin in cirrhotic patients with tense ascites].

Some studies have demonstrated that paracentesis for large-volume extraction of ascites produces renal failure and hyponatremia, and intravenous infusion of plasma expanders can overcome this complications. We performed a survey where we compared effectiveness of dextran 70 vs albumin on prevention of adverse effects and cost differences. Two random groups were formed, 8 cirrhotic patients with tense ascites in each group. Paracentesis with extraction of more than 5 liters was performed. The group A received human albumin and group B dextran 70, both received 6 g per liter of extracted liquid. 24 hours before and 48 hours after of ascites extraction, we performed hepatic function test, blood chemistry with renin and aldosterone. Clinical results and biochemistry test were similar in both groups without statistical significance (p > 0.05). Amount of plasma expander was almost the same, but the cost in group A was $266 USD and in group B $20.8 USD. Azotemia was present in 12.5% in group A and hyponatremia in 12.5% in both groups, without symptoms. The results show that dextran 70 produces the same effect like albumin in the treatment of ascites after large-volume paracentesis with lower cost.

Aged↗

PubMed1996

Comparison of the Caldwell needle/cannula with Angiocath needle in large volume paracentesis.

OBJECTIVE: To evaluate the efficacy and safety of a newly designed paracentesis needle, the Caldwell needle/ cannula (CNC), and to compare it with the Angiocath needle for large volume paracentesis (LVP). METHODS: Forty patients (ages, 18-75 yr) with symptomatic non-malignant ascites and serum creatinines < 1.6 were randomized to undergo LVP with either the 15-gauge CNC or the 14-gauge Angiocath needle. LVP was considered complete when the ascitic fluid was believed to have been completely removed, a goal of 6 L was attained, or fluid return was poor despite clinically obvious ascites. Outcome parameters measured included time necessary for the LVP, amount of ascitic fluid removed, number of peritoneal punctures, and the reason for termination of LVP. Ascitic fluid from eight patients was used to measure in vitro flow rates for both needles at -80, -120, and -200 mm Hg. RESULTS: Twenty patients underwent LVP with the CNC and 20 with the Angiocath. Patients in whom the CNC was used had significantly faster paracenteses (17.0 +/- 0.8 vs. 34.1 +/- 1.5 min) and required fewer second peritoneal punctures (1 vs. 6, p = 0.046). Fewer LVPs in the CNC group were terminated secondary to poor fluid return (8 vs. 1, p = 0.022). The volume of fluid removed was greater with the CNC than with the Angiocath, but this difference did not reach statistical significance (5205 +/- 209 vs. 4683 +/- 269 ml, p = 0.079). There were no complications in either group. In vitro flow rates were 2.2-3.8 times faster through the CNC than through the Angiocath at all pressures tested (p < 0.05 for all groups). CONCLUSIONS: The CNC provides a faster, more complete paracentesis requiring fewer peritoneal punctures than a single-bore needle.

Adult↗

PubMed1997

Acute hemoperitoneum after large-volume paracentesis.

Hemoperitoneum resulting from rupture of mesenteric varices is a rare complication of portal hypertension with a high mortality of up to 70%. This case report describes the symptoms, clinical course, and treatment of 4 patients with acute hemoperitoneum caused by mesenteric variceal bleeding after large-volume paracentesis. Abdominal pain and/or hemorrhagic shock developed in 4 patients (age, 48-68 years), admitted for refractory ascites, 3 hours to 4 days after 1-4 large-volume paracenteses (> 4000 mL). Duplex sonography, performed in 3 of the 4 patients before onset of bleeding, showed retrograde flow in the mesenteric veins, suggesting large-caliber mesenteric collateralization. Treatment consisted of surgical ligation followed by transjugular intrahepatic portosystemic shunt (TIPS) (2 patients) and emergency TIPS with embolization of the bleeding vessel (1 patient). One patient died before any intervention could be initiated. In these 4 patients, the concurrence of large-volume paracentesis and hemoperitoneum suggests their causal relationship. The mechanism may be a sudden reduction in intraperitoneal pressure increasing the pressure gradient across the wall of the mesenteric varices, resulting in rupture and bleeding. The awareness of this complication may accelerate the diagnostic process and treatment.

Acute Disease↗

PubMed1997

Reinfusion of concentrated ascitic fluid versus total paracentesis. A randomized prospective trial.

We compared the efficacy and safety of apheresis and reinfusion of concentrated ascites (ARCA) versus total paracentesis plus intravenous albumin (PARA) in a prospective trial on cirrhotic patients with tense ascites. Twenty-four patients were randomized to either ARCA (N = 12) or PARA (N = 12), and followed for two years. Sex, age, Child's class, and renal and liver function were similar in the two groups. The times the procedures were 2.7 +/- 1.0 (ARCA) vs 2.2 +/- 1.1 (PARA) hr, with removal of 8.8 +/- 3.5 (ARCA) and 6.9 +/- 3.4 (PARA) liters of ascites and intravenous infusion of 59.8 +/- 35.2 (ARCA) and 42.5 +/- 20.5 (PARA) g of albumin. Both procedures were safe. Biochemical signs of coagulative disturbances having no clinical relevance were observed after ARCA, with an increase in prothrombin time (P = 0.005) and serum FSP (P = 0.02). No significant changes in renal function, serum albumin, or plasma and urinary electrocytes were shown. Plasma renin activity increased after PARA (P = 0.02) and plasma atrial natriuretic factor increased after ARCA (P = 0.008), although no differences were observed in diuresis in the immediate follow-up. During the long-term follow-up, patient survival and recurrence of tense ascites were the same in both groups. We conclude that apheresis and reinfusion of concentrated ascites are as safe and effective as total paracentesis with albumin infusion for the treatment of tense ascites in cirrhotic patients.

Adult↗

PubMed2001

EUS in the detection of ascites and EUS-guided paracentesis.

BACKGROUND: The utility of EUS was evaluated for detection of ascites and EUS-guided FNA of ascites in patients undergoing EUS for diagnosis and staging of GI malignancies. METHODS: A series (from March 1994 to October 1997) of 571 consecutive patients who underwent upper EUS for various indications was retrospectively reviewed. Follow-up clinical information was obtained from referring physicians, subsequent CT, and telephone interviews. RESULTS: Eighty-five patients (15% of series) were found to have ascites by EUS. Six did not have CT before EUS. Pre-EUS CT identified ascites in only 14 (18%) of the 79 patients who had pre-EUS CT. Of the patients in whom CT was negative for abdominal fluid (n = 65) and who had clinical follow-up, 13 of 58 (22%) subsequently had ascites develop that were detected by CT or physical examination. Overall, 31 of the 85 patients underwent EUS-guided FNA paracentesis; the mean volume obtained was 7.9 mL (range 1-40 mL). In 5 patients, malignant ascites was diagnosed by EUS-guided FNA; in these patients surgery was avoided. CONCLUSIONS: EUS is more sensitive than CT in detecting small amounts of ascites. A significant number (22%) of patients who had ascites by EUS subsequently had ascites develop that was detectable by CT or physical examination. EUS-guided paracentesis appears to be safe and effective and can identify malignant ascites.

Ascites↗

PubMed2006

Anterior chamber paracentesis cytology (cytospin technique) for the diagnosis of intraocular lymphoma.

AIM: To report on the diagnosis of intraocular lymphoma by aqueous cytology. METHODS: Four patients suspected of having intraocular lymphoma were evaluated by anterior chamber (AC) paracentesis with cytology (cytospin technique). All had a history of non-ocular lymphoma and presented with at least one plus anterior chamber cells despite intensive glucocorticoid therapy. A 25 gauge needle was inserted through clear cornea (bevel up), over the iris stroma, so as to drain the AC. The aqueous humour was sent for cytopathology (cytospin technique), culture, and sensitivity tests. RESULTS: All procedures were diagnostic. Three were lymphoma and the fourth was culture positive for Propionibacterium endophthalmitis. No secondary glaucoma, hyphaema, cataract or infections were related to AC paracentesis. CONCLUSIONS: In this series, AC aspiration cytology enhanced by the cytospin technique was an effective, minimally invasive alternative to vitrectomy based biopsy. This technique should be considered to rule in the diagnosis of intraocular lymphoma in selected cases with cells in the anterior chamber.

Aged↗

PubMed2002

The development of clinical guidelines on paracentesis for ascites related to malignancy.

Malignancy-related ascites gives rise to troublesome symptoms and carries a poor prognosis. Abdominal paracentesis is a widely used and effective procedure for symptom relief, but practice with regard to the procedure itself may vary considerably. Evidence obtained in the context of liver disease probably influences practice in malignancy, although the pathophysiology involved is different. Anecdotal evidence suggested a difference in practice between the Exeter and District Hospice and the adjoining hospital, and this was confirmed by a review of case notes. Patients undergoing paracentesis in the hospital were more likely to have prior ultrasound assessment and to be given intravenous fluids, and had longer drainage times and longer inpatient stays. It seemed that some practices were placing unnecessary burdens on patients whose life expectancy was short. A set of clinical guidelines for the procedure was drawn up, based on the limited evidence available and the practice within the hospice. These guidelines emphasise performing ultrasound investigations only in cases of diagnostic uncertainty, allowing up to 5 L of fluid to drain without clamping, leaving drains in for no more than 6 h and giving intravenous fluids only when specifically indicated. These guidelines were introduced on the oncology ward of the adjoining hospital. The impact on practice was assessed by means of a retrospective case note review of all procedures carried out on the ward in the 6 months before and after the guidelines were introduced. The introduction of guidelines resulted in significant reductions in prior ultrasound assessment, mean length of time drains were left in and mean length of inpatient stay for planned procedures. There were no cases of symptomatic hypotension in the postguidelines group.

Adult↗