EFFECTS OF LARGE-VOLUME PARACENTESIS ON PULMONARY-FUNCTION IN PATIENTS WITH TENSE CIRRHOTIC ASCITES

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.