Brexit from current guideline recommendations?

Dear Editor, We appreciate the interest of O'Brien et al in our position paper recently published in Gut.1 O'Brien et al raised a very important question: is human serum albumin (HSA) the best resuscitation fluid in patients with cirrhosis and acute kidney injury (AKI)? In our minds, as in that of almost all experts in this field, the answer is absolutely yes. This certainty is based on several clinical and experimental evidences and cannot be challenged by studies performed in critically ill patients that are inconsistent for this purpose considering (a) the low percentage of patients with cirrhosis who were included and (b) the modest doses of HSA that were administered. There are three major indications for the use of HSA in cirrhosis: the prevention of paracentesis-induced circulatory dysfunction, the prevention of AKI following spontaneous bacterial peritonitis (SBP) and the treatment of hepatorenal syndrome (HRS).2...

Source: Gut - October 6, 2016 Category: Gastroenterology Authors: Angeli, P., Piano, S., Arroyo, V., on behalf of the International Club of Ascites Tags: PostScript Source Type: research