Should Albumin Be Given to Cirrhotic Patients Who Undergo Large-Volume Paracentesis?

Although several practice guidelines advocate administration of intravenous (IV) albumin during large-volume paracentesis (LVP), the data behind these recommendations is not robust. Researchers performed a meta-analysis of 17 randomized controlled trials (1225 total patients) to evaluate whether albumin is appropriate for acute treatment of cirrhotic patients with tense ascites who undergo LVP.

In all trials, average volume of ascites removed was >5 L. Among the trials in which albumin was compared with no treatment, the incidence of postparacentesis circulatory dysfunction (PCD; a complication associated with ascites recurrence and hepatorenal syndrome, defined as a ≥50% increase in plasma renin activity) was 17%, versus 73% with no treatme…