Other guidelines include:
- Fluid restriction is not necessary in treating most patient with ascites unless [Na]<125 mmol/L
- Diuretics should be stopped for uncontrolled hepatic encephalopathy, [Na]<120 mmol/L, or creatinine>2 mg/dL
- Avoid ACEI, ARB, propranolol, NSAIDS and ASA in patients with moderate-large ascites
- Serial therapeutic paracentesis or Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure for diuretic-resistant ascites
- All appropriate candidates with cirrhotic ascites should be referred for consideration of liver transplantation
Sigal SH, et al. Restricted use of albumin for spontaneous bacterial peritonitis. Gut 2007; 56: 597
Dever JB, et al. Review article: spontaneous bacterial peritonitis—bacteriology, diagnosis, treatment, risk factors and prevention. Aliment Pharmacol Ther. 2015 Jun;41(11):1116-31.