Harrison's Manual of Medicine 17/e
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Paracentesis

Post-Procedure

The pt should be monitored carefully post-procedure and should be instructed to lie supine in bed for several hours. If persistent fluid leakage occurs, continued bedrest with pressure dressings at the puncture site can be helpful. For pts with hepatic dysfunction undergoing large-volume paracentesis, the sudden reduction in intravascular volume can precipitate hepatorenal syndrome. Administration of 25 g IV albumin following large-volume paracentesis has been shown to decrease the incidence of renal failure post-procedure. Finally, if the ascites fluid analysis shows evidence of spontaneous bacterial peritonitis, then antibiotics (directed toward gram-negative gut bacteria) and IV albumin should be administered as soon as possible.



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