Loading...
Refractory ascites is a severe complication of advanced cirrhosis. Treatment includes placement of a transjugular intrahepatic portosystemic shunt or large-volume paracentesis (LVP) with albumin as needed. Albumin is used as a volume expander to prevent postparacentesis circulatory dysfunction (PCD), which is associated with renal dysfunction, higher mortality, and quicker recurrence of ascites. However, because albumin is expensive and sometimes unavailable, use of vasoconstrictors has been proposed as an alternative treatment to prevent PCD.
To compare the efficacy of these two therapies, investigators randomized 25 patients with cirrhosis and refractory ascites to receive vasoconstrictors — long-acting octreotide (20 mg intramuscularly, t…