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Real-Time Ultrasound-Guided Paracentesis by Radiologists: Near Zero Risk of Hemorrhage without Correction of Coagulopathy

Authors :
Sumit Agarwal
Anil B. Seetharam
Michael W. Rowley
Kevin Hirsch
Source :
Journal of Vascular and Interventional Radiology. 30:259-264
Publication Year :
2019
Publisher :
Elsevier BV, 2019.

Abstract

Purpose To evaluate the rate and risk factors for hemorrhage in patients undergoing real-time, ultrasound-guided paracentesis by radiologists without correction of coagulopathy. Materials and Methods This was a retrospective study of all patients who underwent real-time, ultrasound-guided paracentesis at a single institution over a 2-year period. In total, 3116 paracentesis procedures were performed: 757 (24%) inpatients and 2,359 (76%) outpatients. Ninety-five percent of patients had a diagnosis of cirrhosis. Mean patient age was 56.6 years. Mean international normalized ratio (INR) was 1.6; INR was > 2 in 437 (14%) of cases. Mean platelet count was 122 x 103/μL; platelet count was Results Significant post-paracentesis hemorrhage occurred in 6 (0.19%) patients, and only 1 patient required an angiogram with embolization. No predictors of post-procedure bleeding were found, including INR and platelet count. Transfusion of 1125 units of fresh frozen plasma and 366 units of platelets were avoided, for a transfusion-associated cost savings of $816,000. Conclusions Without correction of coagulation abnormalities with prophylactic blood product transfusion, post-procedural hemorrhage is very rare when paracentesis is performed with real-time ultrasound guidance by radiologists.

Details

ISSN :
10510443
Volume :
30
Database :
OpenAIRE
Journal :
Journal of Vascular and Interventional Radiology
Accession number :
edsair.doi.dedup.....0d3d2363784eb48ef061b538d2f395c8
Full Text :
https://doi.org/10.1016/j.jvir.2018.11.001