Rohit Mehtani Profile picture
May 27 10 tweets 14 min read Twitter logo Read on Twitter
⭐️New-pub alert!!
@APASLnews guidelines on management of #ascites in liver disease.
Salient features covered which are different from other guidelines👇🏻
✅Diagnostic approach to mixed ascites
✅Role of low-dose albumin (1/n)

link.springer.com/article/10.100… Image
✅Recommendations on use of ACE inhibitors/ARBs
✅Diagnostic approach to management of pleural effusion
✅Recommend ICA definition for defining renal dysfunction in refractory ascites
✅Start with low-dose diuretics and gradually increase dose to increase tolerability (2/n)
⭐️Diagnostic algorithm for workup of new onset #ascites 👇🏻

✅SAAG - diagnosis of portal hypertension
✅High SAAG, high protein ascites - use BNP, 2D echo, SPA doppler and thyroid profile
✅Low SAAG, high protein ascites - use ascitic fluid ADA, amylase and TG (3/n) Image
⭐️Diagnostic algorithm for Hyponatremia 👇🏻
✅History & clinical examination to assess volume status
✅Urinary sodium to assess renal loss
✅Rule out adrenal insufficiency and hypothyroidism (4/n) Image
⭐️Diagnostic algorithm for management of pleural effusion in #cirrhosis👇🏻
✅Pleural fluid protein, serum-pleural albumin gradient and pleural-to-serum protein ratio 🔑
✅Neutrophil count > 500 or > 250 (with + culture) - SBE (5/n) Image
⭐️Diagnostic algorithm for management of HRS-AKI👇🏻
✅Treat precipitating events in Stage 1a with volume expansion
✅Consider IV albumin in Stage 1b and higher
✅Add vasoconstrictors to IV albumin (6/n) Image
🔸Read the paper to find out more about day to day challenges faced by the clinicians in managing ascites and its complications in liver disease.

link.springer.com/article/10.100…

Special thanks to Prof. Virendra Singh, @doc_arka sir and @drshivsarin sir for giving me this opportunity!

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