Clinical, Biochemical and Haemodynamic Effects of Large-volume Paracentesis (LVP) in Inflammatory Situations

Clinical, Biochemical and Haemodynamic Effects of Large-volume Paracentesis (LVP) in Inflammatory Situations

This observational study evaluates the clinical, biochemical and haemodynamic effects of large-volume paracentesis (LVP) in 50 patients with and without signs of inflammation

Ascites is one of the common complications in advanced liver cirrhosis. Large-volume paracentesis (LVP) is a widely used symptomatic intervention to remove large amounts of peritoneal fluid. Despite a low rate of interventional-associated complications like fistula or non life-threatening bleeding LVP induces an impairment of circulatory function. The hypothesis is that haemodynamic changes can be detected by non-invasive monitoring and that these haemodynamic changes could be associated to postinterventional organ dysfunction or complications. Additionally the investigators hypothesize that paracentesis-induced circulatory dysfunction could also be associated to present clinical and laboratory signs of inflammation or infection and could influenced by increased viable and non-viable bacterial translocation.

Inclusion Criteria:

• Female and male Patients between 18-70 years with liver cirrhosis and ascites
• Indication for paracentesis

Exclusion Criteria:

• Infectious disease in the last 4 weeks
• Active alcohol-consumption or missing data of alcohol use
• Missing inform consent
• Missing speech comprehension
• Neurological or psychiatric disease that compromise consenting
• Hepatic encephalopathy stage III (West-Haven criteria)
• Heart failure NYHA IV
• Renal insufficiency or hepatorenal syndrome
• Atrial fibrillation
• Pacemaker