{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:31:50Z","timestamp":1785472310699,"version":"3.56.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T00:00:00Z","timestamp":1594252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T00:00:00Z","timestamp":1594252800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Paracentesis\u2010induced circulatory dysfunction (PICD) is a serious complication of large\u2010volume (&gt;5\u00a0L) paracentesis in cirrhosis and is reduced with albumin infusion. There is a lack of data on PICD in acute\u2010on\u2010chronic liver failure (ACLF). Because ACLF patients have greater hemodynamic derangements than patients with decompensated cirrhosis, we investigated whether PICD could develop with modest\u2010volume paracentesis (MVP) and the role of albumin infusion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>A total of 80 ACLF patients undergoing &lt;5\u00a0L paracentesis were randomized to receive albumin (8 g\/dL of ascitic fluid; n\u00a0=\u00a040) or no albumin (n\u00a0=\u00a040) and serially followed to detect PICD. Baseline characteristics were comparable between groups, including volume of ascitic tap (4.16\u00a0\u00b1\u00a00.23 versus 4.14\u00a0\u00b1\u00a00.27 L; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.72) and plasma renin activity (PRA; 20.5\u00a0\u00b1\u00a07.03 versus 23.2\u00a0\u00b1\u00a08.24\u00a0ng\/mL\/hour; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.12). PICD was more frequent in the no\u2010albumin group than the albumin group (70% versus 30%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001), with higher incidence of hepatic encephalopathy (50% versus 27.5%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.04), hyponatremia (67.5% versus 22.5%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001), acute kidney injury (62.5% versus 30%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001), and in\u2010house mortality (62.5% versus 27.5%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.003). PRA of 25.15\u00a0ng\/mL at day 3 had sensitivity and specificity of 71% and 68%, respectively, for development of PICD at day 6. Albumin infusion decreased the incidence of PICD at day 6 (odds ratio, 0.068; 95% confidence interval, 0.011\u20100.43; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.005).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>PICD is common and develops even with MVP in ACLF patients. Albumin infusion decreases the incidence of PICD and mortality in patients with ACLF. Clinical trial identifier: NCT02467348<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31071","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T06:55:55Z","timestamp":1576652155000},"page":"1043-1055","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":68,"title":["Paracentesis\u2010Induced Circulatory Dysfunction With Modest\u2010Volume Paracentesis Is Partly Ameliorated by Albumin Infusion in Acute\u2010on\u2010Chronic Liver Failure"],"prefix":"10.1097","volume":"72","author":[{"given":"Vinod","family":"Arora","sequence":"first","affiliation":[{"name":"Department of Hepatology,Institute of Liver and Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajan","family":"Vijayaraghavan","sequence":"additional","affiliation":[{"name":"Department of Hepatology,Institute of Liver and Biliary Sciences,New 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