Long term abdominal drains in end stage cirrhosis

Conditions

Topic: Gastroenterology

Cooper M, Pollard A, Pandey A, Bremner S, Macken L, Evans CJ, Austin M, Parnell N, Steer S, Thomson S, Hashim A, Mason L, Verma S.

2020-12-1917 citations

10.1016/j.jpainsymman.2020.12.007

Randomised clinical trial: palliative long‐term abdominal drains vs large‐volume paracentesis in refractory ascites due to cirrhosis

Lucia Macken, Stephen Bremner, Heather Gage, Morro Touray, Peter Williams et al. (20 authors)

Alimentary Pharmacology & Therapeutics2020-06-0159 citations

10.1111/apt.15802

Palliative long-term abdominal drains versus repeated drainage in individuals with untreatable ascites due to advanced cirrhosis: study protocol for a feasibility randomised controlled trial.

Macken L, Mason L, Evans C, Gage H, Jordan J, Austin M, Parnell N, Cooper M, Steer S, Boles J, Bremner S, Lambert D, Crook D, Earl G, Timeyin J, Verma S.

2018-07-2713 citations

10.1186/s13063-018-2779-0

Interventions

Patients will be randomly allocated to one of two groups: Group 1: Patients receive current standard care only (hospital based abdominal drainage) Group 2: Patients ha

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Aged 18 years or over 2. Presence of untreatable (refractory) ascites, defined as: 2.1. Ascites that are unresponsive to fluid and sodium restriction and high dose diuretic treatment (spironolactone 400 mg and or furosemide 160 mg) and/or intolerance of diuretics 2.2. Recurs rapidly after LVP (need for one or more LVP per month). 3. Child Pugh Score of greater than 9. unless specifically decided by the medical team that they are to receive only palliative treatment. If less than 9, the participant is considered palliative by medical team. 4. 4. Registered with a GP in Brighton and Hove or West Sussex with community Integrated Primary Care Team provision from Sussex Community NHS Trust 5. Ability to speak read and understand English 6. Capacity to give informed consent as defined using the Capacity to Consent Checklist 7. Signed, informed consent prior to any study specific procedures

Exclusion criteria

Exclusion criteria: 1. Either loculated or chylous ascites 2. Presence of > grade 1 hepatic encephalopathy (specified by West Haven Criteria – appendix 13) 3. Evidence of active infection that in the investigator’s opinion would preclude insertion of LTAD (for example, bacterial peritonitis) – such patients would need to receive appropriate treatment and could then be reconsidered 4. A candidate for liver transplantation 5. Psychosocial issues which in the opinion of the medical team will preclude study participation

Design outcomes

Primary

Measure	Time frame
Acceptability of LTAD to patients/carers and staff to be measured at end of study (3 months) or at the time of patient death, which ever occurs first.	—

Secondary

Measure	Time frame
There are no secondary outcome measures.	—

Countries

United Kingdom

Outcome results

None listed