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large volume paracentesis

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https://www.readbyqxmd.com/read/29738325/automated-low-flow-ascites-pump-in-a-real-world-setting-complications-and-outcomes
#1
Philipp Solbach, Christoph Höner Zu Siederdissen, Freya Wellhöner, Nicolas Richter, Benjamin Heidrich, Henrike Lenzen, Port Kerstin, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIMS: The aim of this study was to investigate the Alfapump, an automated low-flow pump system for the treatment of refractory ascites (RA) as an alternative for repeated large-volume paracentesis in patients with contraindication for placement of a transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation. MATERIALS AND METHODS: In 21 consecutive patients with RA and contraindication for a placement of a TIPS, the Alfapump was implanted at Hannover Medical School between December 2012 and May 2016...
May 7, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29624508/viscoleastic-tamponade-applied-to-the-ocular-surface-for-enhanced-control-of-gaseous-egress-from-the-anterior-chamber-during-final-bubble-titration-in-dmek-surgery-the-polite-burp
#2
Christopher S Sales, Ana Alzaga Fernandez, Zane Anwar
PURPOSE: To present a novel technique for enhancing the surgeon's control over the volume of air or gas that is "burped" from the anterior chamber during final bubble and intraocular pressure (IOP) titration in Descemet membrane endothelial keratoplasty. METHODS: After ascertaining that the intracameral bubble is either too large and/or has rendered IOP too high, a bead of ophthalmic viscoelastic is applied to the ocular surface over a paracentesis incision, which is then depressed in the usual fashion to burp gas from the anterior chamber...
April 5, 2018: Cornea
https://www.readbyqxmd.com/read/29609068/cost-effectiveness-of-early-insertion-of-transjugular-intrahepatic-portosystemic-shunts-for-recurrent-ascites
#3
Nicole T Shen, Yecheskel Schneider, Stephen E Congly, Russell E Rosenblatt, Yunseok Namn, Brett E Fortune, Arun Jesudian, Robert S Brown
BACKGROUND & AIMS: Treatment options for recurrent ascites resulting from decompensated cirrhosis include serial large volume paracentesis and albumin infusion (LVP+A) or insertion of a transjugular intrahepatic portosystemic shunt (TIPS). Insertion of TIPSs with covered stents during early stages of ascites (early TIPS, defined as 2 LVPs within the past 3 weeks and less than 6 LVPs in the prior 3 months) significantly improves chances of survival and reduces complications of cirrhosis compared to LVP+A...
March 30, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29566477/severe-intraperitoneal-hemorrhage-from-pseudoaneurysm-after-a-large-volume-paracentesis-successfully-treated-with-microcoil-embolization
#4
Soo Hyung Ryu, Dong Il Kwon
Large-volume paracentesis-induced intraperitoneal hemorrhage due to pseudoaneurysm formation is rarely reported. Here, we present a 56-year-old man with alcoholic liver cirrhosis admitted for massive ascites. Large-volume paracentesis was performed. Three days later, he became pale and complained of dyspnea and abdominal distention with hypotension. Percutaneous iliac angiography revealed contrast media leakage from a branch of the left circumflex iliac artery with pseudoaneurysm. He was successfully treated with microcoil embolization...
March 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29557942/development-and-validation-of-a-patient-reported-outcome-measurement-for-symptom-assessment-in-cirrhotic-ascites
#5
Myrte Neijenhuis, Tom J G Gevers, Thomas D Atwell, Tim J Gunneson, Amanda C Schimek, Wietske Kievit, Joost P H Drenth, Patrick S Kamath
OBJECTIVES: As current treatments of cirrhotic ascites are not associated with survival benefit, symptom relief is the major therapeutic end point. We developed a questionnaire (Ascites-Q; modified polycystic liver disease questionnaire) and assessed validity and responsiveness for symptom assessment in cirrhotic ascites. METHODS: Ascites-Q was compared with Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI; developed for malignant ascites) and Japanese Ascites Symptom Inventory-7 (ASI-7) in cirrhotics undergoing large-volume paracentesis...
April 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29538440/impact-of-large-volume-paracentesis-on-respiratory-parameters-including-transpulmonary-pressure-and-on-transpulmonary-thermodilution-derived-hemodynamics-a-prospective-study
#6
Ulrich Mayr, Eugen Karsten, Tobias Lahmer, Sebastian Rasch, Philipp Thies, Benedikt Henschel, Gerrit Fischer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites...
2018: PloS One
https://www.readbyqxmd.com/read/29507899/exploring-opportunities-to-prevent-cirrhosis-admissions-in-the-emergency-department-a-multicenter-multidisciplinary-survey
#7
Shazia Mehmood Siddique, Meghan Lane-Fall, Matthew J McConnell, Neha Jakhete, James Crismale, Stefanie Porges, Vandana Khungar, Shivan J Mehta, David Goldberg, Zhiping Li, Thomas Schiano, Linda Regan, Clinton Orloski, Judy A Shea
Patients with cirrhosis have high admission and readmission rates, and it is estimated that a quarter are potentially preventable. Little data are available regarding nonmedical factors impacting triage decisions in this patient population. This study sought to explore such factors as well as to determine provider perspectives on low-acuity clinical presentations to the emergency department, including ascites and hepatic encephalopathy. A survey was distributed in four liver transplant centers to both emergency medicine and hepatology providers, who included attending physicians, house staff, and advanced practitioners; 196 surveys were returned (estimated response rate 50...
March 2018: Hepatology communications
https://www.readbyqxmd.com/read/29460201/patients-with-refractory-ascites-treated-with-alfapump%C3%A2-system-have-better-health-related-quality-of-life-as-compared-to-those-treated-with-large-volume-paracentesis-the-results-of-a-multicenter-randomized-controlled-study
#8
Maria Stepanova, Fatema Nader, Christophe Bureau, Danielle Adebayo, Laure Elkrief, Dominique Valla, Markus Peck-Radosavljevic, Anne McCune, Victor Vargas, Macarena Simon-Talero, Juan Cordoba, Paolo Angeli, Silvia Rossi, Stewart MacDonald, Jeroen Capel, Rajiv Jalan, Zobair M Younossi
BACKGROUND: Refractory ascites (RA) is a complication of cirrhosis which is treated with large volume paracentesis (LVP) as the standard of care. Alfapump® system is a fully implantable pump system which reduces the need for LVP. The aim was to assess health-related quality of life (HRQL) in patients treated with alfapump® versus LVP. METHODS: The data were collected in a multicenter open-label randomized controlled trial (clinicaltrials.gov #NCT01528410). Subjects with cirrhosis Child-Pugh class B or C accompanied by RA were randomized to receive alfapump® or LVP...
February 19, 2018: Quality of Life Research
https://www.readbyqxmd.com/read/29411667/prognosis-of-patients-with-ascites-after-pleurx-insertion-an-observational-study
#9
Agnete Nordheim Riedel, Nina Kimer, Lise Hobolth, Lise Lotte Gluud
OBJECTIVE: To evaluate the safety of PleurX in cirrhotic patients with refractory ascites. METHODS: We prospectively registered patients who received a PleurX catheter cirrhosis-associated refractory ascites at our department from July 2015 to November 2016. Our control group consisted of matched cirrhotic patients with refractory ascites treated with large volume paracentesis (LVP) and patients with malignant ascites treated with PleurX during the same period. RESULTS: We included 25 patients with cirrhosis-related ascites (7 in PleurX group) and 17 with malignant ascites (14 in PleurX group)...
March 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29395458/corrigendum-to-alfapump%C3%A2-system-vs-large-volume-paracentesis-for-refractory-ascites-a-multicenter-randomized-controlled-study-j-hepatol-67-2017-940-949
#10
Christophe Bureau, Danielle Adebayo, Mael Chalret de Rieu, Laure Elkrief, Dominique Valla, Markus Peck-Radosavljevic, Anne McCune, Reyad Abbadi, Victor Vargas, Macarena Simon-Talero, Juan Cordoba, Paolo Angeli, Silvia Rosi, Stewart MacDonald, Massimo Malago, Maria Stepanova, Zobair M Younossi, Claudia Trepte, Randall Watson, Oleg Borisenko, Sun Sun, Neil Inhaber, Rajiv Jalan
No abstract text is available yet for this article.
March 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29393567/acute-kidney-injury-but-not-sepsis-is-associated-with-higher-procedure-related-bleeding-in-patients-with-decompensated-cirrhosis
#11
Adelina Hung, Guadalupe Garcia-Tsao
BACKGROUND: Bleeding after low-risk invasive procedures can be life-threatening or can lead to further complications in decompensated cirrhosis patients. In unstratified cohorts of hospitalized patients with cirrhosis, the rate of procedure-related bleeding is low despite abnormal coagulation parameters. Our objective was to identify patients with decompensated cirrhosis at a high risk of developing procedure-related bleeding in whom the value of pre-procedure transfusions could be assessed...
February 2, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29378312/under-dilated-tips-associate-with-efficacy-and-reduced-encephalopathy-in-a-prospective-non-randomized-study-of-patients-with-cirrhosis
#12
Filippo Schepis, Francesco Vizzutti, Guadalupe Garcia-Tsao, Guido Marzocchi, Luigi Rega, Nicola De Maria, Tommaso Di Maira, Stefano Gitto, Cristian Caporali, Stefano Colopi, Mario De Santis, Umberto Arena, Antonio Rampoldi, Aldo Airoldi, Alessandro Cannavale, Fabrizio Fanelli, Cristina Mosconi, Matteo Renzulli, Roberto Agazzi, Roberto Nani, Pietro Quaretti, Ilaria Fiorina, Lorenzo Moramarco, Roberto Miraglia, Angelo Luca, Raffaele Bruno, Stefano Fagiuoli, Rita Golfieri, Pietro Torricelli, Fabrizio Di Benedetto, Luca Saverio Belli, Federico Banchelli, Giacomo Laffi, Fabio Marra, Erica Villa
BACKGROUND & AIMS: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time...
March 3, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29311195/peritoneal-dialysis-is-feasible-as-a-bridge-to-combined-liver-kidney-transplant
#13
Ruth Ellen Jones, Yun Liang, Malcolm MacConmara, Christine Hwang, Ramesh Saxena
Patients with combined liver and kidney failure may remain on dialysis for years while awaiting simultaneous liver-kidney transplantation (SLKT). The role of peritoneal dialysis (PD) in patients with advanced liver and kidney failure awaiting SLKT remains to be defined. We present our single-institution experience with PD in cirrhotics, 3 of whom went on to receive successful SLKT. Patients initiated in our PD program between 2006 and 2016 who had both liver and kidney failure were identified. Medical and dialysis records were reviewed retrospectively...
January 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29261352/incrementally-expandable-transjugular-intrahepatic-portosystemic-shunts-single-center-experience
#14
Jie Cui, Sara E Smolinski, Fengyong Liu, Dihua Xu, Kal Dulaimy, Zubin Irani
OBJECTIVE: The purpose of this study is to investigate the long-term safety and efficacy of a small-diameter expandable transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension. MATERIALS AND METHODS: This single-center retrospective study included 28 patients (12 women and 16 men; mean age, 56.9 years) who underwent small-diameter expandable TIPS creation between 2008 and 2010 for refractory ascites (n = 15; mean [± SD] model for end-stage liver disease [MELD] score, 15...
February 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29226410/editorial-alfapump-an-alternative-to-large-volume-paracentesis-for-patients-with-refractory-ascites-authors-reply
#15
EDITORIAL
G Stirnimann, A De Gottardi
No abstract text is available yet for this article.
January 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29226396/editorial-alfapump-an-alternative-to-large-volume-paracentesis-for-patients-with-refractory-ascites
#16
EDITORIAL
S Macdonald, R Jalan
No abstract text is available yet for this article.
January 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29210304/current-management-of-refractory-ascites-in-patients-with-cirrhosis
#17
Ruihong Zhao, Juan Lu, Yu Shi, Hong Zhao, Kaijin Xu, Jifang Sheng
Liver cirrhosis is a health problem worldwide, and ascites is its principal symptom. Refractory ascites is intractable and occurs in 5%-10% of all patients with ascites due to cirrhosis. Refractory ascites leads to a poor quality of life and high mortality rate. Ascites develops as a result of portal hypertension, which leads to water-sodium retention and renal failure. Various therapeutic measures can be used for refractory ascites, including large-volume paracentesis, transjugular intrahepatic portosystemic shunt, vasoconstrictive drugs, and an automated low-flow ascites pump system...
March 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29150405/cirrhosis-with-ascites-in-the-last-year-of-life-a-nationwide-analysis-of-factors-shaping-costs-health-care-use-and-place-of-death-in-england
#18
Benjamin Hudson, Jeff Round, Brendan Georgeson, Andrew Pring, Karen Forbes, Catherine Anne McCune, Julia Verne
BACKGROUND: Liver disease mortality increased by 400% in the UK between 1970 and 2010, resulting in rising pressures on acute hospital services, and an increasing need for end-of-life care. We aimed to assess the effect of demographic, clinical, and health-care factors on costs, patterns of health-care use, and place of death in a national cohort of patients with cirrhosis and ascites in their last year of life. METHODS: We did a retrospective, nationwide analysis of all patients who died from cirrhosis in England between 2013 and 2015, who required large-volume paracentesis in their last year of life...
February 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29142455/large-volume-paracentesis-up-to-27-l-with-adjuvant-vaginal-cabergoline-in-the-case-of-severe-ovarian-hyperstimulation-syndrome-with-successful-pregnancy-outcome-a-case-report
#19
Nupur Agarwal, Sanghamitra Ghosh, Shikha Bathwal, Baidyanath Chakravarty
Severe ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening complication of assisted reproductive technology. Herein, we report the case of an infertile couple, with the husband being azoospermic, who underwent in-vitro fertilisation and intracytoplasmic sperm injection at our institute. The woman presented with late OHSS 7 days after embryo transfer. Inpatient management was performed with intensive surveillance. Oral cabergoline was started prophylactically but was replaced by the vaginal route due to intolerance...
July 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/29132516/decompensated-cirrhosis-and-fluid-resuscitation
#20
REVIEW
Erin Maynard
The critically ill patient with decompensated cirrhosis has a unique physiology and alterations in albumin that need to be understood to properly resuscitate them and minimize morbidity and mortality. Little data exist on specific resuscitation of the patient with cirrhosis compared with those patients without liver disease. The effectiveness of albumin administration compared with saline administration in common settings, such as large-volume paracentesis, can be extrapolated to the care of the general surgical patient but further studies in this area are warranted...
December 2017: Surgical Clinics of North America
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