Hemodynamic Variability During Drainage of Large Volumes of Malignant Ascites in Patients With Cancer

This study compared the variability in mean arterial pressure (MAP) during drainage of ascites in patients with cancer who underwent drainage of a large (5–10 L) or small (<5 L) volume of ascites. We prospectively enrolled 50 patients scheduled for cell-free and concentrated ascites reinfusion therapy. Equivalence was considered to be established if the 95% confidence interval (95% CI) for the highest variability rate of MAP was within ±20%. The median volume of ascites removed was 3.30 L (95% CI [2.84, 4.40]) in the small-drainage-volume group (n = 15) and 6.75 L (95% CI [6.40, 7.30]) in the large-drainage-volume group (n = 34). The 95% CIs for the highest variability rates in MAP ranged from −19.60 to −6.23 and from −19.16 to −12.95 (p = .594), respectively, indicating equivalence. These findings indicate that variability in MAP during drainage of ascites is not dependent on drainage volume.

[1]  P. Caraceni,et al.  Management of Ascites in Patients with Cirrhosis: An Update , 2021, Journal of clinical medicine.

[2]  P. Hayes,et al.  Guidelines on the management of ascites in cirrhosis , 2020, Gut.

[3]  K. Orihashi,et al.  Feasibility, efficacy, and safety of cell-free and concentrated ascites reinfusion therapy (KM-CART) for malignant ascites. , 2020, Artificial organs.

[4]  T. Fülöp,et al.  Reinterpreting Renal Hemodynamics: The Importance of Venous Congestion and Effective Organ Perfusion in Acute Kidney Injury. , 2020, The American journal of the medical sciences.

[5]  M. Bednaříková,et al.  WNT signaling inducing activity in ascites predicts poor outcome in ovarian cancer , 2020, Theranostics.

[6]  B. Badgwell,et al.  Palliation of malignant ascites , 2019, Journal of surgical oncology.

[7]  A. Şahin,et al.  The effect of patient positions on perfusion index , 2018, BMC Anesthesiology.

[8]  T. Luukkaala,et al.  Therapeutic Procedures for Malignant Ascites in a Palliative Care Outpatient Clinic. , 2018, Journal of palliative medicine.

[9]  M. Stukan Drainage of malignant ascites: patient selection and perspectives , 2017, Cancer management and research.

[10]  L. Alloy,et al.  Atypical reactivity of heart rate variability to stress and depression across development: Systematic review of the literature and directions for future research. , 2016, Clinical psychology review.

[11]  Steven A Julious,et al.  Practical guide to sample size calculations: non‐inferiority and equivalence trials , 2016, Pharmaceutical statistics.

[12]  J. Michael Textbook of Medical Physiology , 2005 .

[13]  J. Gilbert,et al.  The development of clinical guidelines on paracentesis for ascites related to malignancy , 2002, Palliative medicine.

[14]  M. Maynar,et al.  Abdominal decompression plays a major role in early postparacentesis haemodynamic changes in cirrhotic patients with tense ascites , 2001, Gut.

[15]  D. Wittmann,et al.  The Compartment Syndrome of the Abdominal Cavity: A State of the Art Review , 2000 .