Ascitic fluid accumulation

Evaluate effectiveness of diuretic therapy with regard to ascitic fluid accumulation and development of peripheral edema. Ask the patient directed questions about abdominal girth, fullness, tenderness, and pain. Weigh the patient at each visit, and ask the patient to keep a weight diary. Assess for peripheral edema at each visit. 

Ascites. Patients with cirrhosis, especially fiver cirrhosis, very often develop ascites, ie, accumulation of fluid in the peritoneal cavity. This is the final event resulting from the hemodynamic disturbances in the systemic and splanchnic circulations that lead to sodium and water retention. When therapy with a low sodium diet fails, the dmg of choice for the treatment of ascites is furosemide, a high ceiling (loop) diuretic, or spironolactone, an aldosterone receptor antagonist/potassium-sparing diuretic. 

In obese patients or those with only small amounts of fluid accumulation, ultrasound evaluation may be necessary to detect ascites with certainty. 

The goals of treating ascites are to minimize acute discomfort, re-equilibrate ascitic fluid, and prevent SBP. Treatment should modify the underlying disease pathology without directed therapy, fluid will rapidly re-accumulate. 

Ascites Abnormal accumulation of serous fluid in the spaces between tissues and organs in the peritoneal cavity of the abdomen. 

Necropsies for pathological study were performed promptly on moribund mice which were killed within 2 hours of injection of toxin-LR. Mouse livers were dark red, markedly enlarged, and engorged with blood. The observed 50 percent increase in fresh weight of the liver is attributed to the accumulation of about one-half of the total circulating blood in and around hepatic blood channels. The cerebral cortex was slightly swollen and pale, and a thin film of pink ascitic fluid was sometimes seen. No other abnormalities were observed. 

Senger DR, Galli SJ, Dvorak AM, et al. Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. Science 1983 219 983-985. 

Ascites. Excessive accumulation of serious fluid in the peritoneal (abdominal) cavity. 

OHSS is characterized by cystic ovarian enlargement, increased capillary permeability, and third space fluid accumulation (that is in an extracellular compartment that is not in equilibrium with either the extracellular or intracellular fluid, for example the bowel lumen, subcutaneous tissues, retroperitoneal space, or peritoneal cavity). Risk factors include a previous history of OHSS, age under 30 years (probably because more follicles are available), and polycystic ovary syndrome. Non-pregnant patients usually recover within 14 days with supportive treatment. The severe form (with ascites or pleural effusion and hemoconcentration) occurs in 1-10% of patients (64,65). In critical cases, hypoxemia, renal insufficiency, thromboembolism, and rarely death can occur (66). 

Depending on the use of the mAbs, certain adaptations may be required for their preparation. When large quantities of mAbs are required, in vivo production of the antibody in ascitic fluid is not practical, because it will require the use of a large number of animals. Thus, it is often easier to cultivate the antibodies in an appropriate in vitro culture medium. However, given the strict nutritional requirements of the hybridomas and their fragility in the face of osmolality, pH variations, and the accumulation of metabolites, the production of large quantities of antibodies in vitro will necessitate special care. 

Ascites or Ascitic Fluid An accumulation of fluid in the abdominal cavity. 

The child s subsequent course was one of gradual hepatic deterioration.At age 3 years, he was noted to have ascites (intra-abdominal fluid accumulation). This progressed slowly until the age of 6 years, when severe ascites and peripheral edema necessitated the initiation of spironolactone (a potassium-sparing diuretic). Several admissions to the hospital were required over the next 6 years for ascites with scrotal edema. Serum albumin values were persistently low, less than 2.0 g/dL. During this time, the patient also had two episodes of primary peritonitis (intraperitoneal infection) and one episode of a-streptococcal sepsis. 

High blood pressure in the portal vein plus impaired liver function, perhaps leading to fluid accumulation in the abdomen. Ascites, also known as peritoneal cavity fluid, is an accumulation of fluid in the peritoneal cavity. 

This is the presence of excess fluid in the peritoneal cavity, leading to a swollen abdomen (Figure 4.3). The accumulation of ascitic fluid represents a state of sodimn excess in the body. Patients often present with hyponatraemia, but this is thought to be due to the dilutional effect of excess water rather than to low sodium. There are three theories of the cause of ascites formation. The underfill theory suggests that there is a reduction in circulating plasma volume as a result of accumulation in the splanchnic area due to vascular dilatation in portal hypertension. This activates the plasma renin, aldosterone and sympathetic nervous systems, which leads to sodium and water retention by the kidneys. 

Euphorbia kansui Lion (Euphorbiaceae family) is distributed widely in northwest China. The dried roots of the plant are known as kansui and classified as a lower-class medicine. It is used as an herbal remedy for ascites (abdominal fluid accumulation) and cancer in China. 

Renal toxicity has been attributed to sequelae from the development of the capillary leak syndrome. Vascular leak resulted in significant extravascular fluid accumulation (ascites, pleural effusions, peripheral edema) and weight gains of as much as 17 kg in 3 weeks [11]. As in sepsis syndrome, hypotension, oliguria and reduced fractional excretion of sodium accompanied the capillary leak. 

P-ARK An enzyme that phosphoylates the occupied form of a G-protein coupled receptor, e.g. the 6-adrenoceptor, leading to uncoupling of that receptor and desensitization. ARMI age-related memory impairment, arrhythmia (dysrhythmia) An abnormality of heart rhythm or rate of heartbeat, usually caused by disturbance of the electrical impulses and their conduction within the heart. They include ectopic beats (isolated irregular beats), tachycardias (too fast a heartbeat), bradycardias (too slow a heartbeat) and atrial flutter and ventricular fibrillation. Arthus reaction A severe local inflammatory response, a skin reaction characterized by erythema, oedema, necrosis, local haemorrhage. A type III hypersensitivity reaction. Arunlakshana and Schild plot See Schild plot, ascites fluid The fluid that accumulates in the peritoneal cavity during certain pathological conditions, aspiration The withdrawal of fluid or tissue from the body by suction. 

Bradykinin, which has been studied extensively in inflammation, infection and in cancer is an important mediator of the FPR effect. It is well known that bradykinin mediates pain and increases vascular permeability and even angiogenesis We reported previously that the bradykinin-generating cascade is activated in the tumor compartment and that bradykinin may be involved in malignant ascitic and pleural fluid accumulation ... 

Funasaka, T., Haga, A., Raz, A., and Nagase, H., Tumor autocrine motility factor induces hyperper-meabihty of endothehal and mesothelial cells leading to accumulation of ascites fluid. Biochem. Biophys. Res. Commun., 2002,293 192-200. 

---