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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.

A Prospective Small Volume Albumin Therapy in Cirrhosis and Spontaneous Bacterial Peritonitis Treatment

Tsao, Yu-chen 30 July 2008 (has links)
In clinical findings, complications are the major cause of death in cirrhotic patients. Among all the complications, ascites is most frequent type. All cirrhotic patients with ascites could develop spontaneous bacterial peritonitis (SBP). The hospitalized prevalence of SBP was high (30%) in cirrhotic ascites patients. However, the outcome of cirrhotic SBP patients has been improved because of using the antibiotics cephalosporins. Furthermore, treatment with intravenous albumin in addition to cephalosporins reduced the incidence of renal impairment and the mortality in SBP patients in a multicentre study. However, other studies showed that administration of albumin might not work as effectively as other plasma expanders do. Moreover, administration of large volume albumin would make the medication very expensive and might have potential risk of infectious disease, since the therapeutic albumin is extracted from human plasma. Therefore, to treat patients with large volume albumin become disputable. In this study, we evaluated the effects of small volume intravenous albumin with cephalosporins treatments through monitoring patients¡¦ renal and hepatic functions and related inflammatory markers. Results showed that plasma TNF-£\, £LL-6 and ascites endotoxin, TNF-£\ and IL-6 levels were significantly reduced in patients treated with cephalosporins plus small volume albumin, but not in those treated with cephalosporins alone. Also, the combination therapy of cephalosporins and small volume albumin avoid the dramatically elevation of plasma and ascites nitric oxide, as well as the further degree of renal function impairment. The positive results of this study laid a solid foundation for a large scale investigation.

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