The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner

Nooman Gilani, Nayan Patel, Richard D. Gerkin, Francisco C Ramirez, Erin E. Tharalson, Kandarp Patel

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Due to time constraints, fewer physicians are performing large volume paracentesis (LVP) resulting in a longer wait time and more emergency department (ED) and hospital admissions. At our institution, after initial supervision, a certified nurse practitioner (NP) has independently performed LVP in a dedicated cirrhosis clinic. The purpose of our study was to evaluate the feasibility and safety of LVP performed by a NP. A retrospective review of patients undergoing LVP between January 2003 and May 2007 was performed. Baseline patient information and the practitioner performing LVP (physician or NP) were recorded. Complications including post paracentesis hypotension, bleeding, local leakage of ascitic fluid, infection, perforation, and death were compared between the two groups. A total of 245 procedures in 41 patients were performed by a single NP, and 244 in 43 patients by physicians. Baseline characteristics of patients undergoing LVP were similar in two groups. Alcohol was the most common etiology of cirrhosis (46% in NP and 51% in physician group) followed by a combination of alcohol plus HCV (37% in NP and 28% in physician group). There was similar distribution of Childs class B and C patients in the two groups, as well as average MELD score. Total volume of ascites removed, number of needle attempts, and complications including post paracentesis hypotension, local leakage of ascitic fluid, bleeding, infection, and death were not statistically different between the two groups. Our study shows no difference between physician and NP performance of LVP and complication rates. LVP performed by a NP is feasible and has acceptable rate of complications.

Original languageEnglish (US)
Pages (from-to)359-363
Number of pages5
JournalAnnals of Hepatology
Volume8
Issue number4
StatePublished - Oct 2009
Externally publishedYes

Fingerprint

Paracentesis
Nurse Practitioners
Safety
Physicians
Ascitic Fluid
Hypotension
Fibrosis
Alcohols
Hemorrhage
Infection
Ascites
Needles
Hospital Emergency Service

Keywords

  • Ascites
  • Cirrhosis
  • Nurse practitioner's role
  • Paracentesis

ASJC Scopus subject areas

  • Hepatology
  • Medicine(all)

Cite this

Gilani, N., Patel, N., Gerkin, R. D., Ramirez, F. C., Tharalson, E. E., & Patel, K. (2009). The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner. Annals of Hepatology, 8(4), 359-363.

The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner. / Gilani, Nooman; Patel, Nayan; Gerkin, Richard D.; Ramirez, Francisco C; Tharalson, Erin E.; Patel, Kandarp.

In: Annals of Hepatology, Vol. 8, No. 4, 10.2009, p. 359-363.

Research output: Contribution to journalArticle

Gilani, N, Patel, N, Gerkin, RD, Ramirez, FC, Tharalson, EE & Patel, K 2009, 'The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner', Annals of Hepatology, vol. 8, no. 4, pp. 359-363.
Gilani, Nooman ; Patel, Nayan ; Gerkin, Richard D. ; Ramirez, Francisco C ; Tharalson, Erin E. ; Patel, Kandarp. / The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner. In: Annals of Hepatology. 2009 ; Vol. 8, No. 4. pp. 359-363.
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