At yesterday’s morning report in Parkland we had a great discussion about treating ascites. Below is a link to the most updated guidelines regarding ascites management in cirrhosis from the American Association for the Study of Liver Diseases (AASLD) published in February 2013.
Some key points from the guidelines include:
-Since bleeding is uncommon during diagnostic paracentesis, routine prophylactic use of platelets and fresh frozen plasma are not recommended (Class III, Level C).
-Initial laboratory tests for ascitic fluid should include cell differential count, ascitic total protein and SAAG (Class I, Level B).
-Sodium restriction (less than 2000mg per day) and diuretics (spironolactone with or without furosemide) is first line therapy in cirrhotics with ascites (Class IIa, Level A).