How To Use Continuous Wall Suction for Paracentesis

 

Recommended limits for total fluid removal vary depending on the source, but the consensus among guidelines is 5–6 liters without the need for volume expanders to lessen chances of major complications.

 

Paracentesis (ascitic tap)…

Paracentesis is usually done in a lateral decubitus position (or supine, for large volumes). The level of the ascites fluid is percussed and a needle is inserted in either in the midline(2-3 cm below umbilicus) or lateral lower quadrant (lateral to rectus abdominus muscle, 2-4 cm superomedial to anterior superior iliac spine). This positioning prevents puncture of the inferior epigastric arteries; visible superficial veins and surgical scars should be avoided too. To reduce risk of ascites fluid leak, the needle is inserted either with a z-tracking technique, or at a 45-degree angle.

Albumin for Patients with Spontaneous Bacterial Peritonitis or Large Volume Paracentesis

The current recommendation from the American Association for the Study of Liver Disease (AASLD) is to consider the administration of albumin (6-8 g/L of fluid removed) ONLY for patients undergoing removal of greater than 5 liters.

Using wall suction to drain that ascites

Recommended limits for total fluid removal vary depending on the source, but the consensus among guidelines is 5–6 liters without the need for volume expanders to lessen chances of major complications.