Safety and Efficacy of Small Frequent Paracentesis Using an Indwelling CAtheter Compared With Repeated Large Volume Paracentesis in Cirrhotic Patients With REfractory Ascites

NCT ID: NCT04406298

Last Updated: 2020-07-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-04

Study Completion Date

2021-05-20

Brief Summary

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The aim of the study is to assess the efficacy of intermittent small quantity (upto 3L per day) paracentesis through an indwelling catheter for up to 5 days in comparison with large volume paracentesis on decreasing the need for repeated paracentesis by 50 % over next 3 months. The project will be conducted at ILBS between April 2020 and March 2021. The concept of the study is to evaluate the efficacy of indwelling catheter in reducing the refilling rates of ascites by 50 % over 3 months in comparison to LVPs and also in reducing the incidence and risk of PPCD. All refractory ascites patients will be included as per inclusion and exclusion criteria, after taking informed consent from the patient or their relatives.

The expected outcomes are

Primary outcome: Proportion of cirrhotic patients with refractory ascites achieving at least 50 % reduction on need for large volume paracentesis after a short duration (5day) intermittent small quantity (up to 3L/ day) paracentesis through an indwelling catheter in comparison to a single large volume paracentesis in the next 3 months.

Secondary outcome:

1\. Proportion of cirrhotic patients with refractory ascites developing P 2 . During a 30 D, 60 D and 90 D follow up, to assess between the groups

* Need for repeated paracentesis : Number assessed
* AKI : Improvement or worsening of renal functions
* Hepatic encephalopathy: Grading as per West Haven Classification
* Hyponatremia
* Diuretic tolerability : Dose and duration tolerated
* Bacterial peritonitis : Ascitic fluid neutrophil count \> 250 cells/cumm
* Transplant free survival
* Risk of procedure related complications
* Changes in MELD or CTP between the groups ( Improvement vs worsening )
* Need for hospitalization between the groups

Detailed Description

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Conditions

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Liver Cirrhosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Small Quantity Paracentesis

Intermittent small quantity (upto 3L per day) paracentesis through an indwelling catheter for up to 5 days.

Group Type EXPERIMENTAL

small quantity paracentesis

Intervention Type PROCEDURE

Intermittent small quantity paracentesis (upto 3L/day) for upto 5 days

Large Volume Paracentesis

Large Volume Paracentesis \> 5 litres

Group Type ACTIVE_COMPARATOR

Large Volume Paracentesis

Intervention Type PROCEDURE

Large Volume Paracentesis \> 5litres

Interventions

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small quantity paracentesis

Intermittent small quantity paracentesis (upto 3L/day) for upto 5 days

Intervention Type PROCEDURE

Large Volume Paracentesis

Large Volume Paracentesis \> 5litres

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Cirrhotic patients 18-70 yrs with refractory severe ascites with stable renal function (S.creatinine \< 2 mg/dl).

Exclusion Criteria

* CTP \>12, MELD\>25
* Prior or current Spontaneous Bacterial Peritonitis (SBP)
* Recurrent or current overt hepatic encephalopathy
* Serum Creatinine \>2
* HVOTO (Hepatic Venous Outflow Tract Obstruction)
* Hepatic or extrahepatic malignancy
* Recent UGI bleed
* Sepsis
* Serum Sodium \< 120
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute of Liver and Biliary Sciences, India

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Institute of Liver & Biliary Sciences

New Delhi, National Capital Territory of Delhi, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Dr Manasa Alla, MD

Role: CONTACT

01146300000

Facility Contacts

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Dr Manasa Alla, MD

Role: primary

01146300000

Other Identifiers

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ILBS-Cirrhosis-29

Identifier Type: -

Identifier Source: org_study_id

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