Paracentesis-induced circulatory dysfunction (PICD) is a complication which can be prevented by the administration of plasma expanders.
In this study, researchers from Spain compared the efficacy of saline versus albumin for the prevention of PICD.
| No differences were found when < 6 liters of ascitic fluid was evacuated.|
They randomized patients to receive either albumin or saline following total paracentesis. After randomization, 35 patients received saline and 37 received albumin.
In addition, 21 patients readmitted with a second episode of tense ascites were treated with total paracentesis and the alternative plasma expander.
The team found significant increases in plasma renin activity (PRA) both 24 hours and 6 days after paracentesis in the saline group; no changes were observed with albumin.
They also found that incidence of PICD was significantly higher in the saline group versus the albumin group (33% versus 11%, respectively).
However, no significant differences were found when less than 6 liters of ascitic fluid was evacuated.
Furthermore, the researchers observed similar results when analyzing patients who received 2 consecutive paracentesis.
Dr Javier Sola-Vera's team concluded, "Albumin is more effective than saline in the prevention of PICD".
"Saline is a valid alternative to albumin when less than 6 liters of ascitic fluid is evacuated".