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

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.
Date30 July 2008
CreatorsTsao, Yu-chen
ContributorsWen-chun Hung, Angela Chen, Deng-chyang Wu
Source SetsNSYSU Electronic Thesis and Dissertation Archive
Detected LanguageEnglish
Rightscampus_withheld, Copyright information available at source archive

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