Paracentesis-induced inflammation: A new syndrome?

摘要

Decompensated cirrhosis is diagnosed by the presence of signs such as ascites, gastrointestinal haemorrhage, hepatic encephalopathy, bacterial infection or any combination of these (1). Ascites is the most common sign of decompensated cirrhosis (1). Ascites is primarily related to an inability to excrete an adequate amount of sodium into urine, leading to a positive sodium balance (2). Renal sodium retention in patients with cirrhosis is secondary to arterial splanchnic vasodilatidn. This causes a decrease in effective arterial blood volume with unloading of arterial and cardiopulmonary volume receptors, and subsequent 'reflex' activation of vasoconstrictor and sodium-retaining systems (i.e. the sympathetic nervous system and the renin-angiotensin-aldosterone system, RAAS). Renal sodium retention leads to extracellular fluid volume expansion and formation of ascites and oedema (2).