1. Cirrhosis With Refractory Ascites: Serial Large Volume Paracentesis, TIPS, or Transplantation? 
Vandana Khungar, Sammy Saab 
Clinical Gastroenterology and Hepatology 
Volume 9, Issue 11, Pages (November 2011)
DOI: /j.cgh
Copyright © 2011 AGA Institute Terms and Conditions

2. Figure 1
Suggested approach to the cirrhotic patient with ascites not responsive to diuretics. GI, gastrointestinal; NSAID, nonsteroidal anti-inflammatory drug; OLT, orthotopic liver transplant; SBP, spontaneous bacterial peritonitis. †Lack of response defined as mean weight loss <0.8 kg over 4 days and urinary sodium output less than sodium intake on intensive diuretic therapy (spironolactone 400 mg by mouth daily and furosemide 160 mg by mouth daily) for at least 1 week and on a sodium restricted diet of <90 mmol/L per day or 5.2 g of salt per day. ‡Refractory ascites defined by the International Ascites Club is either: (1) diuretic resistant ascites—ascites that cannot be mobilized or the early recurrence of which cannot be prevented because of a lack of response to dietary sodium restriction and intensive diuretic treatment; or (2) diuretic-intractable ascites—ascites that cannot be mobilized or the early recurrence of which cannot be prevented because of the development of diuretic-induced complications that preclude the use of an effective diuretic dosage.
Clinical Gastroenterology and Hepatology 2011 9, DOI: ( /j.cgh )
Copyright © 2011 AGA Institute Terms and Conditions