Ce. Angueira et Sc. Kadakia, EFFECTS OF LARGE-VOLUME PARACENTESIS ON PULMONARY-FUNCTION IN PATIENTS WITH TENSE CIRRHOTIC ASCITES, Hepatology, 20(4), 1994, pp. 825-828
Large-volume paracentesis is an accepted therapeutic modality for the
treatment of tense ascites in patients with cirrhosis. Whereas the eff
ects of large-volume paracentesis on the cardiovascular system have be
en studied in great detail, the effects of tense ascites and large-vol
ume paracentesis on the respiratory system have undergone only limited
evaluation. Most patients report symptomatic improvement in breathing
after large-volume paracentesis. The aim of our study was to prospect
ively evaluate the effects of large-volume paracentesis on the pulmona
ry function of patients with tense ascites. Nine patients with alcohol
ic cirrhosis and tense ascites underwent large-volume paracentesis (me
an, 3,500 ml of ascites removed) followed by intravenous albumin infus
ion (10 gm/L ascites removed). Pulmonary function tests were performed
just before and 2 hr after large-volume paracentesis. The functional
residual capacity increased from 2.46 +/- 0.92 to 2.99 +/- 0.97L (p =
0.01) and total lung capacity from 5.08 +/- 1.18 to 5.72 +/- 1.32 L (p
= 0.03). The forced vital capacity, expiratory reserve volume and res
idual volume also increased but were not statistically significant (p
= 0.07 for all). We noted no significant improvement in forced expirat
ory volume in 1 sec, forced expiratory effort 25% to 75%, vital capaci
ty or diffusion capacity, There was marked symptomatic improvement in
all patients. We conclude that large-volume paracentesis improves meas
ured lung volumes within hours in patients with tense ascites.