© 2002 by Gut
LETTER
Terlipressin and arterial blood volume after paracentesis for tense ascites in cirrhosis
1 St George’s Hospital Medical School, Blackshaw Road, London SW17 OQT, UK; gsinghranger@yahoo.co.uk
Keywords: terlipressin; vasopressin analogue; arterial blood volume; tense ascites; cirrhosis
Abbreviations: coeliac disease; oats; diet
| The first 150 words of the full text of this article appear below. |
Moreau et al described the use of terlipressin, a vasopressin analogue, in ameliorating the reduction in effective arterial blood volume which can occur after paracentesis for tense ascites in cirrhosis (Gut 2002:50:90–4).
The article states that the first 1 mg intravenous bolus dose of terlipressin was given at the onset of paracentesis. Previous work has shown that infusion of vasopressin in a haemodynamically stable circulation can lead to reduced cardiac performance and coronary blood flow.1 Moreover, a sustained pressor response can occur in cirrhotic patients, with reduction in heart rate, cardiac output, hepatic blood flow, and pressor effects also on the pulmonary circulation.2
Although the authors state no episodes of arterial hypertension occurred in the terlipressin group and that there were no observed changes between pre- and post-treatment electrocardiograms (ECGs), it is not clear whether invasive continuous arterial pressure monitoring was employed in this study or
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