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• W3148509314 abstract "Background~Aims: Circulatory abnormalities with activation of vasoconstrictor systems after large-volume paracentesis are generally considered secondary to an increased extravasation of fluid from the intravascular compartment to the extravascular space with subsequent reduction in plasma volume. To test this hypothesis, plasma volume, the transvascular escape rate of albumin, the absolute escape rate of albumin and the activity of vasoconstrictor systems were measured in 25 cirrhotic patients with ascites in baseline conditions and 2 days after total paracentesis with plasma volume expansion. Methods: Plasma volume and the transvascular escape rate of albumin, the fraction of albumin passing from the intravascular to the extravascular space per unit of time, were assessed through the plasma disappearance curve of radioiodinated human albumin. The absolute escape rate of albumin, the total flux of albumin from intravascular to extravascular space per unit of time, was also calculated. Results: Eight of the 25 patients (32%) developed marked activation of vasoconstrictor systems after paracentesis. In these patients, plasma renin activity and plasma norepinephrine concentration increased from 6.6_+2 to 23.4_+11 ng • ml -~ • h -~ and 776_+229 to 989_+258 pg/ml, respectively (p<0.05). No significant changes in these parameters were found in the remaining 17 patients. The activation of vasoconstrictor systems occurred in the absence of changes in plasma volume (3456_+276 vs 3476_+264 ml, NS), transvascular escape rate of albumin (10.4_+1 vs 10.9_+2%/h, NS) and absolute escape rate of albumin (9.9_+1.9 vs 10.5_+0.7 g/h, NS). Conclusions: These results do not support a contraction of plasma volume as the mechanism responsible for activation of vasoconstrictor systems after paracentesis. Rather, the activation of vasoconstrictor systems in the absence of changes in plasma volume suggests that paracentesis accentuates the impairment of effective blood volume present in cirrhotic patients with ascites." @default.
• W3148509314 created "2021-04-13" @default.
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• W3148509314 date "2001-01-01" @default.
• W3148509314 modified "2023-09-23" @default.
• W3148509314 title "Effect of therapeutic paracentesis on plasma volume and transvascular escape rate of albumin in patients with cirrhosis" @default.
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