Effects of plasma expansion with albumin and paracentesis on haemodynamics and kidney function in critically ill cirrhotic patients with tense ascites and hepatorenal syndrome a prospective uncontrolled trial.docVIP

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Effects of plasma expansion with albumin and paracentesis on haemodynamics and kidney function in critically ill cirrhotic patients with tense ascites and hepatorenal syndrome a prospective uncontrolled trial.doc

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Effects of plasma expansion with albumin and paracentesis on haemodynamics and kidney function in critically ill cirrhotic patients with tense ascites and hepatorenal syndrome a prospective uncontrolled trial

Available online /content/12/1/R4 Research Open Access Vol 12 No 1 Effects of plasma expansion with albumin and paracentesis on haemodynamics and kidney function in critically ill cirrhotic patients with tense ascites and hepatorenal syndrome: a prospective uncontrolled trial Andreas Umgelter1, Wolfgang Reindl1, Katrin S Wagner2, Michael Franzen1, Konrad Stock1, Roland M Schmid1 and Wolfgang Huber1 1Medizinische Klinik und Poliklinik der Technischen Universit?t München, Ismaningerstrasse 22, 81675 München, Germany 2Klinik für Kardiologie und Internistische Intensivmedizin, Klinikum Bogenhausen, St?dtisches Klinikum München GmbH, Englschalkinger Strasse 77, 81925 München, Germany Corresponding author: Andreas Umgelter, andreas.umgelter@lrz.tu-muenchen.de Received: 2 Oct 2007 Revisions requested: 24 Nov 2007 Revisions received: 27 Nov 2007 Accepted: 15 Jan 2008 Published: 15 Jan 2008 Critical Care 2008, 12:R4 (doi:10.1186/cc6765) This article is online at: /content/12/1/R4 ? 2008 Umgelter et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Circulatory dysfunction in cirrhotic patients may cause a specific kind of functional renal failure termed hepato- renal syndrome (HRS). It contributes to the high incidence of renal failure in cirrhotic intensive care unit (ICU) patients. Fluid therapy may aggravate renal failure by increasing ascites and intra-abdominal pressure (IAP). This study investigates the short-term effects of paracentesis on haemodynamics and kidney function in volume resuscitated patients with HRS. 1 m-2 (4.0 to 5.8), whereas systemic vascular resistance index (SVRI) decreased from 1,422 dyn s cm-5 m-2 (1,081 to 1,772) to 1,171 dyn s cm-5 m-2 (893 to 1,705). Cr