Hemaccel as a cheaper alternative to human albumin for plasma expansion during paracentesis in cirrhotic patients

Aim: to find out if intravenous hemaccel (polygelene) is equally as effective for plasma volume expansion and prevention of hemodynamic changes during large volume paracentesis in cirrhotic patients with tense ascites. design: comparative study. setting: medical department,akhter saeed trust hospital,from march 2014 to may,2015 methods: fifty patients with cirrhosis admitted for the management of tense ascites were randomly divided in two groups of twenty five patients each. group a received intravenous albumin in a dose of six grams/ liter of ascitic fluid removed and group b received polygelene (hemaccel) in a dose of 125 ml/ liter of ascites removed. various hemodynamic and renal parameters were assessed immediately before and six days after the procedure. results: the various parameters observed (expressed as mean±sd) before / after the procedure are: urea 43.7±12.2/41.2±12.2mg/dl for group a and 45.2±12.1/42.3±11.4mg/dl for group b (χ2=0.35 p<0.05). serum creatinine 1.4±0.4/1.3±0.6mg/dl for group a and 1.3±1.1/1.3±0.8mg/dl for group b. serum sodium 134.5±2.9/131.5±2.4 for group a and 134.9±6.5/134.2±4.3mmol/l for group b. (χ2=0.48,p<0.05). plasma osmolality 300.7± 8.6 / 296.1 ± 9.0mosmol/l for group a and 302.8±10.6/297.6±9.23 mosmol/l for group b (χ2 0.4,p<0.05). calculated gfr 74.3±17.7/78.2±19.7ml/min for group a and 75.5±15. /77.9±2.4ml/min for group b (χ2=0.73,p<0.05),and mean arterial pressure 98.8±8.3/94.0±6.1mmhg for group a and 98.2±10.6/93.7±6.7mmhg for group b (χ2 =0.29,p<0.05). conclusion: it was concluded that hemaccel is as effective as albumin in preventing hemodynamic disturbances following large volume paracentsis in patients with cirrhosis and tense ascites.