This week we dive into a recent journal article questioning whether we should tap all ascites.
Episode 123.0 – Paracentesis Journal Update
Show Notes
Take Home Points
- SBP is a difficult diagnosis to make clinically. While patients may have the triad of fever, abdominal pain and increasing ascites, they are far more likely to only have 1 or 2 of these symptoms
- In patients admitted to the hospital with ascites, consider performing a diagnostic paracentesis on all patients as limited literature shows an association with decreased mortality and, the procedure is simple and low risk
- Once you get the fluid, focus on the cell count: WBC > 500 or PMN > 250 should prompt treatment with a 3rd generation cephalosporin and albumin infusion
Gaetano et al. The benefit of paracentesis on hospitalized adults with cirrhosis and ascites. Journal of Gastroenterology and Hepatology 2016. PMID: 26642977
Read More
EMRAP: C3 Live Paracentesis Video
LITFL: Spontaneous Bacterial Peritonitis
SinaiEM: SBP Pearls
REBEL EM: Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)?
Approach to the Diagnosis and Treatment of SBP (University of Washington)
