Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites

Angelo Luca, Fausto Feu, Juan Carlos García-Pagán, Wladimiro Jiménez, Vicente Arroyo, Jaime Bosch, Juan Rodés

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Total paracentesis is widely used in the treatment of patients with cirrhosis and tense ascites. However, very little information is available regarding its consequences on splanchnic circulation, and its effects on portocollateral blood flow have not been investigated. Ten cirrhotic patients admitted because of tense ascites had measurements of hepatic and systemic hemodynamics, renal function and endogenous vasoactive neurohumoral systems at baseline, just after total paracentesis and 1 hr later. Total paracentesis caused a significant increase in cardiac output (+11%; 95% confidence interval, +4% to + 19%) and a rapid fall in portal pressure, as shown by significant decreases in both the wedged hepatic venous pressure (-27% ± 8%; p <0.005) and the hepatic venous pressure gradient (-10%; 95% confidence interval, -3% to -18%). This was accompanied by a marked decrease in azygos blood flow (-28%; 95% confidence interval, -13% to -43%). These favorable hemodynamic effects were associated with a fall of the elevated levels of plasma renin activity (-47% ±9%; p <0.05), plasma aldosterone (-31% ± 21%; p <0.05), and plasma norepinephrine and by a decrease in levels of serum creatinine (-24% ± 15%; p <0.05) and blood urea nitrogen (-4% ±3%; p <0.05). These changes were maintained 1 hr later. This study indicates that in patients with cirrhosis and tense ascites total paracentesis favorably influences the systemic hemodynamics, portocollateral blood flow and portal pressure.

Original languageEnglish
Pages (from-to)30-33
Number of pages4
JournalHepatology
Volume20
Issue number1 PART 1
Publication statusPublished - Jul 1994

Fingerprint

Paracentesis
Viscera
Ascites
Hemodynamics
Portal Pressure
Venous Pressure
Confidence Intervals
Liver
Fibrosis
Splanchnic Circulation
Blood Urea Nitrogen
Aldosterone
Renin
Cardiac Output
Creatinine
Norepinephrine
Blood Pressure
Kidney
Serum

ASJC Scopus subject areas

  • Hepatology

Cite this

Luca, A., Feu, F., García-Pagán, J. C., Jiménez, W., Arroyo, V., Bosch, J., & Rodés, J. (1994). Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites. Hepatology, 20(1 PART 1), 30-33.

Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites. / Luca, Angelo; Feu, Fausto; García-Pagán, Juan Carlos; Jiménez, Wladimiro; Arroyo, Vicente; Bosch, Jaime; Rodés, Juan.

In: Hepatology, Vol. 20, No. 1 PART 1, 07.1994, p. 30-33.

Research output: Contribution to journalArticle

Luca, A, Feu, F, García-Pagán, JC, Jiménez, W, Arroyo, V, Bosch, J & Rodés, J 1994, 'Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites', Hepatology, vol. 20, no. 1 PART 1, pp. 30-33.
Luca A, Feu F, García-Pagán JC, Jiménez W, Arroyo V, Bosch J et al. Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites. Hepatology. 1994 Jul;20(1 PART 1):30-33.
Luca, Angelo ; Feu, Fausto ; García-Pagán, Juan Carlos ; Jiménez, Wladimiro ; Arroyo, Vicente ; Bosch, Jaime ; Rodés, Juan. / Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites. In: Hepatology. 1994 ; Vol. 20, No. 1 PART 1. pp. 30-33.
@article{eeac46c751cf4b389d8f53b0055467c3,
title = "Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites",
abstract = "Total paracentesis is widely used in the treatment of patients with cirrhosis and tense ascites. However, very little information is available regarding its consequences on splanchnic circulation, and its effects on portocollateral blood flow have not been investigated. Ten cirrhotic patients admitted because of tense ascites had measurements of hepatic and systemic hemodynamics, renal function and endogenous vasoactive neurohumoral systems at baseline, just after total paracentesis and 1 hr later. Total paracentesis caused a significant increase in cardiac output (+11{\%}; 95{\%} confidence interval, +4{\%} to + 19{\%}) and a rapid fall in portal pressure, as shown by significant decreases in both the wedged hepatic venous pressure (-27{\%} ± 8{\%}; p <0.005) and the hepatic venous pressure gradient (-10{\%}; 95{\%} confidence interval, -3{\%} to -18{\%}). This was accompanied by a marked decrease in azygos blood flow (-28{\%}; 95{\%} confidence interval, -13{\%} to -43{\%}). These favorable hemodynamic effects were associated with a fall of the elevated levels of plasma renin activity (-47{\%} ±9{\%}; p <0.05), plasma aldosterone (-31{\%} ± 21{\%}; p <0.05), and plasma norepinephrine and by a decrease in levels of serum creatinine (-24{\%} ± 15{\%}; p <0.05) and blood urea nitrogen (-4{\%} ±3{\%}; p <0.05). These changes were maintained 1 hr later. This study indicates that in patients with cirrhosis and tense ascites total paracentesis favorably influences the systemic hemodynamics, portocollateral blood flow and portal pressure.",
author = "Angelo Luca and Fausto Feu and Garc{\'i}a-Pag{\'a}n, {Juan Carlos} and Wladimiro Jim{\'e}nez and Vicente Arroyo and Jaime Bosch and Juan Rod{\'e}s",
year = "1994",
month = "7",
language = "English",
volume = "20",
pages = "30--33",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Inc.",
number = "1 PART 1",

}

TY - JOUR

T1 - Favorable effects of total paracentesis on splanchnic hemodynamics in cirrhotic patients with tense ascites

AU - Luca, Angelo

AU - Feu, Fausto

AU - García-Pagán, Juan Carlos

AU - Jiménez, Wladimiro

AU - Arroyo, Vicente

AU - Bosch, Jaime

AU - Rodés, Juan

PY - 1994/7

Y1 - 1994/7

N2 - Total paracentesis is widely used in the treatment of patients with cirrhosis and tense ascites. However, very little information is available regarding its consequences on splanchnic circulation, and its effects on portocollateral blood flow have not been investigated. Ten cirrhotic patients admitted because of tense ascites had measurements of hepatic and systemic hemodynamics, renal function and endogenous vasoactive neurohumoral systems at baseline, just after total paracentesis and 1 hr later. Total paracentesis caused a significant increase in cardiac output (+11%; 95% confidence interval, +4% to + 19%) and a rapid fall in portal pressure, as shown by significant decreases in both the wedged hepatic venous pressure (-27% ± 8%; p <0.005) and the hepatic venous pressure gradient (-10%; 95% confidence interval, -3% to -18%). This was accompanied by a marked decrease in azygos blood flow (-28%; 95% confidence interval, -13% to -43%). These favorable hemodynamic effects were associated with a fall of the elevated levels of plasma renin activity (-47% ±9%; p <0.05), plasma aldosterone (-31% ± 21%; p <0.05), and plasma norepinephrine and by a decrease in levels of serum creatinine (-24% ± 15%; p <0.05) and blood urea nitrogen (-4% ±3%; p <0.05). These changes were maintained 1 hr later. This study indicates that in patients with cirrhosis and tense ascites total paracentesis favorably influences the systemic hemodynamics, portocollateral blood flow and portal pressure.

AB - Total paracentesis is widely used in the treatment of patients with cirrhosis and tense ascites. However, very little information is available regarding its consequences on splanchnic circulation, and its effects on portocollateral blood flow have not been investigated. Ten cirrhotic patients admitted because of tense ascites had measurements of hepatic and systemic hemodynamics, renal function and endogenous vasoactive neurohumoral systems at baseline, just after total paracentesis and 1 hr later. Total paracentesis caused a significant increase in cardiac output (+11%; 95% confidence interval, +4% to + 19%) and a rapid fall in portal pressure, as shown by significant decreases in both the wedged hepatic venous pressure (-27% ± 8%; p <0.005) and the hepatic venous pressure gradient (-10%; 95% confidence interval, -3% to -18%). This was accompanied by a marked decrease in azygos blood flow (-28%; 95% confidence interval, -13% to -43%). These favorable hemodynamic effects were associated with a fall of the elevated levels of plasma renin activity (-47% ±9%; p <0.05), plasma aldosterone (-31% ± 21%; p <0.05), and plasma norepinephrine and by a decrease in levels of serum creatinine (-24% ± 15%; p <0.05) and blood urea nitrogen (-4% ±3%; p <0.05). These changes were maintained 1 hr later. This study indicates that in patients with cirrhosis and tense ascites total paracentesis favorably influences the systemic hemodynamics, portocollateral blood flow and portal pressure.

UR - http://www.scopus.com/inward/record.url?scp=0028237009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028237009&partnerID=8YFLogxK

M3 - Article

C2 - 8020901

AN - SCOPUS:0028237009

VL - 20

SP - 30

EP - 33

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 1 PART 1

ER -