Medical Journal of the Islamic Republic Of Iran

en Evaluation of Outcomes and Complications of Large Volume Paracentesis without Albumin and Coagulopathy Therapy in Pediatrics with Severe Ascites Pediatric Pediatric Original Research: Clinical Science Original Research: Clinical Science Background: Large-volume paracentesis has become the first treatment choice for patients with severe and refractory ascites. The studies have reported several complications after therapeutic paracentesis. But there are few published data on the complications with or without Albumin therapy.  We aimed to analyze the safety and complications of large-volume paracentesis in children with or without albumin therapy.    Methods: This study was conducted on children with severe ascites with chronic liver disease who underwent large-volume paracentesis. They were divided into albumin-infused and albumin non-infused groups. In the case of coagulopathy, no adjustment was made. Albumin was not administered after the procedure. The outcomes were monitored to evaluate the complications. To compare two groups, a t-test was utilized, and the ANOVA test was used to compare several groups. If the requirements for using these tests were not met, Mann-Whitney and Kruskal-Wallis tests were applied.    Results: Decreased heart rate was observed in all time intervals and was meaningful six days after paracentesis. MAP also decreased statistically at 48 hours and six days after the procedure (P < 0.05). Other variables did not show any meaningful change.    Conclusion: Children having tense ascites with thrombocytopenia, prolonged PT, Child-Pugh class C, and encephalopathy can undergo large-volume paracentesis without any complication. Albumin administration before the procedure in patients with low levels of Albumin (<2.9) can effectively overcome the problems of tachycardia and increased mean arterial pressure. There will be no need for Albumin administration after paracentesis.     Paracentesis, Cirrhosis, Albumin, Children, Pediatric, Complications, Ascites 383 391 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7660-1&slc_lang=en&sid=1 Mahmoud Haghighat haghighm@sums.ac.ir 200319475328460077233 200319475328460077233 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Naser Honar honorn@sums.ac.ir 200319475328460077234 200319475328460077234 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mohammad Hadi Imanieh Imaniehm@sums.ac.ir 200319475328460077235 200319475328460077235 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Maryam Ataollahi maaolahi@sums.ac.ir 200319475328460077236 200319475328460077236 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Seyed Mohsen Dehghani Dehghanism@gmail.com 200319475328460077237 200319475328460077237 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Iraj Shahramian Ir_buper@yahoo.com 200319475328460077238 200319475328460077238 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Fereshteh Karbasian Karbasian.md@gmail.com 200319475328460077239 200319475328460077239 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Hamideh Komeily Fard h.komeilyfard@resident.mui.ac.ir 200319475328460077240 200319475328460077240 No Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Marzieh Soheili soheili_md@yahoo.com 200319475328460077241 200319475328460077241 Yes Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Seyede Maryam Mahdavi Mortazavi m_mahdavi@sums.ac.ir 200319475328460077242 200319475328460077242 No Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran