Ascitic fluid removal: does it cause renal or hemodynamic decompensation?1

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Twenty-seven patients with cirrhotic ascites lost variable amounts of weight (0–19.7 kg) as a result of ascitic fluid removal during peritoneoscopy. No attempt was made to correct these fluid losses, yet no evidence of untoward hemodynamic, renal, or electrolyte abnormalities was found. The apparent safety of ascites removal, even in large amounts, lends support to the overflow theory of the pathophysiology of ascites formation and also suggests that its role in the clinical management of tense ascites should be reevaluated.



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