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Meeting
Search Results for Paracentesis
Abstract Number: 42
SHM Converge 2021
Background: New internal medicine interns are expected to be familiar with bedside procedures such as paracentesis. Medical students frequently have inadequate dedicated time to learn bedside procedures and are taught in a fragmented manner. As a result, new interns lack familiarity with these procedures. As such, we assessed whether a comprehensive module for paracentesis would […]
Abstract Number: 65
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: The American Board of Internal Medicine suggests residents participate in a minimum of five abdominal paracentesis (AP), central venous catheter (CVC) placements, and lumbar punctures to ensure “adequate knowledge and understanding” of procedures performed by practicing internists. Competency in these procedures is poorly defined and difficult to assess. To address the need for well-supervised, […]
Abstract Number: 113
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Ultrasound-guidance has become the standard for bedside procedures in the emergency and inpatient settings due to its perceived impact on first attempt success and complications. Prior literature on paracentesis notes a 10% rate of overall complications, 5% rate of technical problems, and a 1% rate of bleeding. However, existing cohorts often include outpatients or […]
Abstract Number: 132
SHM Converge 2023
Background: Patients with cirrhosis complicated by ascites are often admitted to the hospital and require abdominal paracentesis for diagnostic evaluation and symptom relief. When large volumes are removed there is a risk for acute kidney injury (AKI) which can contribute to morbidity and mortality. There are no clear guidelines for what constitutes a safe volume […]
Abstract Number: 142
Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.
Background: Ultrasound-guided thoracentesis and paracentesis are frequently performed for both diagnostic and therapeutic indications. While the risk of aspiration is low, our institution has historically required patients to be fasting for 4 hours prior to the procedure. In the hospital setting, unnecessary fasting requirements could contribute to missed patient meals and procedure delays. Here, we […]
Abstract Number: 147
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: Large volume paracentesis is commonly performed in patients with refractory ascites but can induce hypotension and kidney injury. There is evidence that administering albumin at 6-8 grams per liter (g/L) of ascites removed during or after paracentesis can reduce these adverse events. Current guidelines recommend this practice when >2 liters are removed in high-risk […]
Abstract Number: 159
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: Spontaneous Bacterial Peritonitis (SBP) is associated with high mortality. A recent article[1] showed that, in the setting of SBP, delayed paracentesis was associated with increased mortality. Because of the clinical ramifications of this association, we attempted to recreate this finding using our local patient population. Methods: Similar to the study that prompted this inquiry, […]
Abstract Number: 204
Hospital Medicine 2016, March 6-9, San Diego, Calif.
Background: Paracentesis is associated with decreased mortality in patients with advanced liver disease. The prevalence of paracentesis related complications is not well characterized, but prior studies suggest improved safety outcomes when ultrasound guidance is employed. The Agency for Healthcare Research and Quality utilizes patient safety indicator (PSI) 27 to identify postoperative bleeding complications. Our aim […]
Abstract Number: 208
SHM Converge 2021
Background: Therapeutic paracentesis is a common procedure performed to relieve symptoms of ascites most commonly from cirrhosis, heart failure or malignancy. Previous studies have shown that acute kidney injury (AKI) is common after paracentesis and portends a poor prognosis, although these studies have excluded patients with pre-existing chronic kidney disease (CKD). Experiences in our hospital […]
Abstract Number: 243
Hospital Medicine 2018; April 8-11; Orlando, Fla.
Background: Paracentesis is a commonly performed bedside procedure in hospitalized patients. It is often necessary for patients who are taking anticoagulant therapies and/or have disorders of hemostasis. Concerns about bleeding complications often lead to care delays, blood product transfusions, medication changes, and costly labs. Purpose: This study evaluates the safety and clinical outcomes for a […]