Treatment of refractory ascites: Current strategies and new landscape of non-selective beta-blockers
Gastroenterol Hepatol. 2022 Nov;45(9):715-723.
doi: 10.1016/j.gastrohep.2022.02.004.
Epub 2022 Mar 4.
[Article in
English,
Spanish]
Affiliations
- 1 Internal Medicine Service, Regional General Hospital No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro", Mexican Institute of Social Security, Gabriel Mancera 222, Colonia Del Valle, Alcaldía Benito Juárez, Ciudad de Mexico, Mexico.
- 2 Internal Medicine Service, Regional General Hospital No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro", Mexican Institute of Social Security, Gabriel Mancera 222, Colonia Del Valle, Alcaldía Benito Juárez, Ciudad de Mexico, Mexico. Electronic address: dr.luismoreno23@gmail.com.
Abstract
Ascites is the fluid accumulation in the peritoneal cavity, and it is the consequence of a wide variety of entities, being liver cirrhosis the most common one. In this kind of patients, the development of ascites results from splanchnic vasodilation; decreased effective circulating volume; the activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system; and a systemic inflammatory process. Its management is diverse and depends on the severity of the hemodynamic disturbance and other clinical manifestations. In recent years, therapeutic strategies have been developed, but they tend to result unconventional, so new evidence demonstrates the advantages of non-selective beta-blockers for the survival rate of patients with end-stage cirrhosis and ascites.
Keywords:
Ascitis refractaria; Beta-blockers; Betabloqueadores; Cirrosis hepática; Hipertensión portal; Liver cirrhosis; Portal hypertension; Refractory ascites.
Copyright © 2022 Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Adrenergic beta-Antagonists* / pharmacology
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Adrenergic beta-Antagonists* / therapeutic use
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Ascites* / drug therapy
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Ascites* / etiology
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Humans
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Liver Cirrhosis* / complications
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Renin-Angiotensin System / drug effects
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Renin-Angiotensin System / physiology
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Splanchnic Circulation / drug effects
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Splanchnic Circulation / physiology
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Vasodilation / drug effects
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Vasodilation / physiology
Substances
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Adrenergic beta-Antagonists