Norepinephrine in infusion as an alternative to large volume post-paracentesis albumin in patients with cirrhosis

Introduction and Objective

Circulatory dysfunction syndrome (DCIP) occurs in patients who undergo large-volume paracentesis. Albumin should usually be administered to prevent it. However, in many cases, this resource is not available. Singh V, Kumar B, et al. published a study evaluating norepinephrine in preventing DCIP with promising results. This study aimed to assess whether norepinephrine is a helpful resource in preventing DCIP when albumin is unavailable.

Materials and Methods

A prospective, descriptive, and analytical study includes patients with cirrhosis and grade III ascites. Given norepinephrine as an alternative to albumin to prevent DCPI, patients with kidney injury, shunts, and gastrointestinal bleeding were excluded. Descriptive statistics were performed, comparing creatine, Ngal, nystatin C, and sodium at days 0, 3, 6, and 28 days, evaluating whether or not DCPI developed. The trial was approved by the research ethics committee, and informed consent was obtained.

Results

Twelve patients were included, one of whom was ruled out due to precordial pain without electrocardiographic changes; 11 patients were analyzed; 9 men (81.8%); age 52.2 ± 4.5; and 2 (18.2%) P and 9 (81.8%) Child C; 8 (72.7%) due to alcohol, 2 (18.2%) MAFLD, 1 (9.1%) HCV; the drained liters of ascites were 12.5 L with a range of 9 to 18; Renal function measured by creatinine, Cystatin C and NGAL at 0, 3, 6 and 28 days did not show renal dysfunction. The results are shown in Figure 1.

Conclusions

Norepinephrine promises to be an alternative for the preventive management of DCPI.

Funding

The resources used in this study were from the hospital without any additional financing

Declaration of interest

The authors declare no potential conflicts of interest.