Which measures help prevent hypovolemia during paracentesis?

Which measures help prevent hypovolemia during paracentesis?

• A. Rapid drainage and diuretics
• B. Slow drainage and albumin
• C. Immediate transfusion
• D. No fluids

Answer: (B)

The key idea is preventing a drop in effective circulating volume after removing ascitic fluid. When fluid is removed, plasma volume can fall, reducing venous return to the heart and risking hypotension and kidney problems. Draining slowly minimizes abrupt hemodynamic shifts, while giving intravenous albumin after removing a large volume helps expand the plasma volume and maintain oncotic pressure. This combination reduces the likelihood of hypovolemia and circulatory dysfunction. Rapid drainage would cause a sudden decrease in venous return, and diuretics don’t address the acute intravascular volume deficit. No fluids would worsen volume loss, and immediate transfusion is not routinely needed unless there’s another indication.

The key idea is preventing a drop in effective circulating volume after removing ascitic fluid. When fluid is removed, plasma volume can fall, reducing venous return to the heart and risking hypotension and kidney problems. Draining slowly minimizes abrupt hemodynamic shifts, while giving intravenous albumin after removing a large volume helps expand the plasma volume and maintain oncotic pressure. This combination reduces the likelihood of hypovolemia and circulatory dysfunction.

Rapid drainage would cause a sudden decrease in venous return, and diuretics don’t address the acute intravascular volume deficit. No fluids would worsen volume loss, and immediate transfusion is not routinely needed unless there’s another indication.