Paracentesis

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🌱 來自: Huppert’s Notes

Paracentesis🚧 施工中

Paracentesis

•   Indications: 1) All patients with new-onset ascites of uncertain cause, 2) All patients with preexisting ascites in whom SBP is suspected, 3) All patients with cirrhosis and ascites who are being admitted to the hospital

•   Variations: Diagnostic (obtain small sample for testing), therapeutic (large-volume paracentesis)

•   Tests to consider: See Table 4.14

TABLE 4.14 • Laboratory Tests Commonly Ordered to Evaluate Ascites Fluid

•   Relative contraindications: Fluid <2 cm deep from abdominal wall, severe thrombocytopenia (platelet count <50K/μL), DIC; no specific INR cutoff for patients with cirrhosis

•   Complications: Complications of fluid shifts (e.g., hypotension, AKI), abdominal wall hematoma, intraabdominal bleeding, wound infection, persistent leak from the puncture site