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Reinfusion of ascites during hemodialysis as a treatment of massive refractory ascites and acute renal failure.

Hsu TW, Chen YC, Wu MJ, Li AF, Yang WC, Ng YY - Int J Nephrol Renovasc Dis (2011)

Bottom Line: Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, these procedures are performed for ascitic fluid removal without dialytic effect.This procedure can control the rate of ascites and body fluid removal simultaneously during HD using the roller pump.In conclusion, with a normal coagulation profile, the procedure of flow control reinfusion of ascites during HD is an effective alternative treatment for the alleviation of refractory ascites with renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, I-Lan Hospital.

ABSTRACT
Refractory ascites can occur in patients with various conditions. Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, these procedures are performed for ascitic fluid removal without dialytic effect. In this study, a flow control reinfusion of ascites during hemodialysis (HD) was performed to demonstrate the efficacy of this method in a lupus patient with massive refractory ascites and respiratory and acute renal failure (ARF). The alleviation of ascites and ARF attests to the success of the flow control reinfusion of ascites during HD. This procedure can control the rate of ascites and body fluid removal simultaneously during HD using the roller pump. In conclusion, with a normal coagulation profile, the procedure of flow control reinfusion of ascites during HD is an effective alternative treatment for the alleviation of refractory ascites with renal failure.

No MeSH data available.


Related in: MedlinePlus

A) A paracentesis pigtail catheter was inserted into the abdominal cavity to draw out the ascites into the arterial chamber to be mixed with the blood by the flow control roller pump (pump B) during hemodialysis. This procedure allows for control of the flow of ascite reinfusion by the flow control roller pump (pump B) and the amount of body fluid removal by the ultrafiltration rate of the dialyzer simultaneously. B) The abdomen was distended by massive ascites. The superficial veins were also engorged before continuous infusion of ascites into the dialyzer to mix with blood. C) After ascite removal by ascite reinfusion into dialyzer, the distended abdomen and engorged veins disappeared.Abbreviations: H. pump, heparin pump; IV. set, intravenous set; A. Ch, arterial chamber; As. Ch, ascites chamber; V. Ch, venous chamber.
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f1-ijnrd-4-029: A) A paracentesis pigtail catheter was inserted into the abdominal cavity to draw out the ascites into the arterial chamber to be mixed with the blood by the flow control roller pump (pump B) during hemodialysis. This procedure allows for control of the flow of ascite reinfusion by the flow control roller pump (pump B) and the amount of body fluid removal by the ultrafiltration rate of the dialyzer simultaneously. B) The abdomen was distended by massive ascites. The superficial veins were also engorged before continuous infusion of ascites into the dialyzer to mix with blood. C) After ascite removal by ascite reinfusion into dialyzer, the distended abdomen and engorged veins disappeared.Abbreviations: H. pump, heparin pump; IV. set, intravenous set; A. Ch, arterial chamber; As. Ch, ascites chamber; V. Ch, venous chamber.

Mentions: Refractory ascites can occur in patients with conditions such as liver cirrhosis, congestive heart failure, nephrotic syndrome, and lupus serositis1 and in many cases cause abdominal discomfort and respiratory distress to the patient. The treatments for refractory ascites, eg, bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, are usually unsatisfactory. Several procedures based on the reinfusion of ascitic fluid have been performed for ascitic fluid removal.2–8 This report introduces the procedure flow control reinfusion of ascites into the dialyzer during hemodialysis (HD) (Figure 1A), by which a 34-year-old lupus patient with massive ascites, respiratory distress, and acute renal failure (ARF), who did not respond to diuretics, repeated paracentesis with intravenous albumin infusion, and HD, was successfully treated. Prophylactic fresh frozen plasma infusion, sequential ultrafiltration, and reduced dialysate temperature during HD in previous treatments did not prevent intradialytic hypotension. The patient’s symptoms were remedied by seven sessions of flow control reinfusion of ascites during HD (Figure 1B, C).


Reinfusion of ascites during hemodialysis as a treatment of massive refractory ascites and acute renal failure.

Hsu TW, Chen YC, Wu MJ, Li AF, Yang WC, Ng YY - Int J Nephrol Renovasc Dis (2011)

A) A paracentesis pigtail catheter was inserted into the abdominal cavity to draw out the ascites into the arterial chamber to be mixed with the blood by the flow control roller pump (pump B) during hemodialysis. This procedure allows for control of the flow of ascite reinfusion by the flow control roller pump (pump B) and the amount of body fluid removal by the ultrafiltration rate of the dialyzer simultaneously. B) The abdomen was distended by massive ascites. The superficial veins were also engorged before continuous infusion of ascites into the dialyzer to mix with blood. C) After ascite removal by ascite reinfusion into dialyzer, the distended abdomen and engorged veins disappeared.Abbreviations: H. pump, heparin pump; IV. set, intravenous set; A. Ch, arterial chamber; As. Ch, ascites chamber; V. Ch, venous chamber.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3108789&req=5

f1-ijnrd-4-029: A) A paracentesis pigtail catheter was inserted into the abdominal cavity to draw out the ascites into the arterial chamber to be mixed with the blood by the flow control roller pump (pump B) during hemodialysis. This procedure allows for control of the flow of ascite reinfusion by the flow control roller pump (pump B) and the amount of body fluid removal by the ultrafiltration rate of the dialyzer simultaneously. B) The abdomen was distended by massive ascites. The superficial veins were also engorged before continuous infusion of ascites into the dialyzer to mix with blood. C) After ascite removal by ascite reinfusion into dialyzer, the distended abdomen and engorged veins disappeared.Abbreviations: H. pump, heparin pump; IV. set, intravenous set; A. Ch, arterial chamber; As. Ch, ascites chamber; V. Ch, venous chamber.
Mentions: Refractory ascites can occur in patients with conditions such as liver cirrhosis, congestive heart failure, nephrotic syndrome, and lupus serositis1 and in many cases cause abdominal discomfort and respiratory distress to the patient. The treatments for refractory ascites, eg, bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, are usually unsatisfactory. Several procedures based on the reinfusion of ascitic fluid have been performed for ascitic fluid removal.2–8 This report introduces the procedure flow control reinfusion of ascites into the dialyzer during hemodialysis (HD) (Figure 1A), by which a 34-year-old lupus patient with massive ascites, respiratory distress, and acute renal failure (ARF), who did not respond to diuretics, repeated paracentesis with intravenous albumin infusion, and HD, was successfully treated. Prophylactic fresh frozen plasma infusion, sequential ultrafiltration, and reduced dialysate temperature during HD in previous treatments did not prevent intradialytic hypotension. The patient’s symptoms were remedied by seven sessions of flow control reinfusion of ascites during HD (Figure 1B, C).

Bottom Line: Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, these procedures are performed for ascitic fluid removal without dialytic effect.This procedure can control the rate of ascites and body fluid removal simultaneously during HD using the roller pump.In conclusion, with a normal coagulation profile, the procedure of flow control reinfusion of ascites during HD is an effective alternative treatment for the alleviation of refractory ascites with renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, I-Lan Hospital.

ABSTRACT
Refractory ascites can occur in patients with various conditions. Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, these procedures are performed for ascitic fluid removal without dialytic effect. In this study, a flow control reinfusion of ascites during hemodialysis (HD) was performed to demonstrate the efficacy of this method in a lupus patient with massive refractory ascites and respiratory and acute renal failure (ARF). The alleviation of ascites and ARF attests to the success of the flow control reinfusion of ascites during HD. This procedure can control the rate of ascites and body fluid removal simultaneously during HD using the roller pump. In conclusion, with a normal coagulation profile, the procedure of flow control reinfusion of ascites during HD is an effective alternative treatment for the alleviation of refractory ascites with renal failure.

No MeSH data available.


Related in: MedlinePlus