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. 2023 May 1:37:45.
doi: 10.47176/mjiri.37.45. eCollection 2023.

Evaluation of Outcomes and Complications of Large Volume Paracentesis without Albumin and Coagulopathy Therapy in Pediatrics with Severe Ascites

Mahmoud Haghighat  1 , Naser Honar  1 , Mohammad Hadi Imanieh  1 , Maryam Ataollahi  1 , Seyed Mohsen Dehghani  1 , Iraj Shahramian  1 , Fereshteh Karbasian  1 , Hamideh Komeily Fard  2 , Marzieh Soheili  3 , Seyede Maryam Mahdavi Mortazavi  1
Affiliations

Evaluation of Outcomes and Complications of Large Volume Paracentesis without Albumin and Coagulopathy Therapy in Pediatrics with Severe Ascites

Mahmoud Haghighat et al. Med J Islam Repub Iran. .

Abstract

Background: Large-volume paracentesis has become the first treatment choice for patients with severe and refractory ascites. The studies have reported several complications after therapeutic paracentesis. But there are few published data on the complications with or without Albumin therapy. We aimed to analyze the safety and complications of large-volume paracentesis in children with or without albumin therapy.

Methods: This study was conducted on children with severe ascites with chronic liver disease who underwent large-volume paracentesis. They were divided into albumin-infused and albumin non-infused groups. In the case of coagulopathy, no adjustment was made. Albumin was not administered after the procedure. The outcomes were monitored to evaluate the complications. To compare two groups, a t-test was utilized, and the ANOVA test was used to compare several groups. If the requirements for using these tests were not met, Mann-Whitney and Kruskal-Wallis tests were applied.

Results: Decreased heart rate was observed in all time intervals and was meaningful six days after paracentesis. MAP also decreased statistically at 48 hours and six days after the procedure (P < 0.05). Other variables did not show any meaningful change.

Conclusion: Children having tense ascites with thrombocytopenia, prolonged PT, Child-Pugh class C, and encephalopathy can undergo large-volume paracentesis without any complication. Albumin administration before the procedure in patients with low levels of Albumin (<2.9) can effectively overcome the problems of tachycardia and increased mean arterial pressure. There will be no need for Albumin administration after paracentesis.

Keywords: Albumin; Ascites; Children; Cirrhosis; Complications; Paracentesis; Pediatric.

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Conflict of interest statement

The authors declare that they have no competing interests.

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