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Abstract Details
Management of the Adult Patient with Cirrhosis Complicated by Ascites
Crit Care Nurs Clin North Am. 2022 Sep;34(3):311-320.doi: 10.1016/j.cnc.2022.04.005. Epub 2022 Jul 20.
1Department of Digestive Diseases, Cincinnati VA Medical Center, 3200 Vine Street (111-GI), Cincinnati, OH 45220, USA. Electronic address: Anna.Nobbe@va.gov.
2Gastroenterology Section, VA Ann Arbor Healthcare System, 2215 Fuller Road (111D), Ann Arbor, MI 48105, USA. Electronic address: https://twitter.com/hmccurdyNP.
Abstract
Ascites is the most common and often the first decompensating event that occurs in cirrhosis. It has both a high symptom burden and high mortality rate. Increased abdominal girth, generalized abdominal pain, early satiety, and shortness of breath have a negative impact on quality of life. Treatments used to manage ascites include dietary sodium restriction, diuretics, large volume paracentesis, and transjugular intrahepatic portosystemic shunt. Secondary complications of ascites include refractory ascites, hyponatremia, and hepatorenal syndrome and are associated with reduced survival. Consideration should be given to the appropriateness and timing of referrals for liver transplant and/or palliative care.
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