Your browser doesn't support javascript.
loading
Midodrine versus Albumin to Prevent Paracentesis Induced Circulatory Dysfunction in Acute on Chronic Liver Failure Patients in the Outpatient Clinic-a Randomized Controlled Trial.
Sujith Reddy, Jaya Sai N; Jagtap, Nitin; Kalpala, Rakesh; Kulkarni, Anand; Gupta, Rajesh; Nagaraja Rao, Padaki; Iyengar, Sowmya; Alla, Manasa; Nageshwar Reddy, Duvvur; Sharma, Mithun.
Afiliación
  • Sujith Reddy JSN; Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
  • Jagtap N; Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
  • Kalpala R; Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
  • Kulkarni A; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Gupta R; Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
  • Nagaraja Rao P; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Iyengar S; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Alla M; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Nageshwar Reddy D; Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
  • Sharma M; Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India.
J Clin Exp Hepatol ; 13(4): 576-585, 2023.
Article en En | MEDLINE | ID: mdl-37440947
Background: Paracentesis-induced circulatory disturbance (PICD) occurs in 12-20% of patients receiving human albumin for large-volume paracentesis, and can occur at lower than five liter paracentesis in acute-on-chronic liver failure (ACLF). Albumin infusions are associated with higher costs and more prolonged daycare admissions. The aim of the study was to determine if oral midodrine-hydrochloride can prevent PICD in these patients by increasing the mean arterial pressure (MAP). Methods: This open-labeled randomized controlled trial included ACLF patients undergoing paracentesis between 3 and 5 L, who were randomized to receive either 20% human albumin or midodrine hydrochloride 7.5 mg thrice daily for three days, 2 h before paracentesis. MAP was recorded daily. The primary outcome was the plasma renin activity (PRA) on day six, and a 50% increase from baseline was considered PICD. Results: 183 consecutive patients of ACLF were screened, and 50 patients were randomized to either arms. Alcohol was the most common underlying cause of cirrhosis. On day 6, PRA was non-significantly (P = 0.056) higher in the midodrine group. The absolute change of PRA between the two groups was not significant (P = 0.093). Four (16%) patients in the albumin group and five (20%) in the midodrine group developed PICD. MAP increase was not different between the albumin and midodrine arms (P = 0.851). Midodrine was found to be more cost-effective. Conclusions: Three days of oral midodrine is as effective as a human-albumin infusion in preventing PICD in ACLF patients undergoing paracentesis lesser than that done in large volume paracentesis.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: J Clin Exp Hepatol Año: 2023 Tipo del documento: Article País de afiliación: India Pais de publicación: India
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: J Clin Exp Hepatol Año: 2023 Tipo del documento: Article País de afiliación: India Pais de publicación: India