How do you determine whether to limit volume removal during therapeutic paracentesis in a patient without acute or chronic kidney disease?

Large volume paracentesis (LVP) can lead to complications such as post paracentesis circulatory dysfunction. In patients who have ongoing acute renal failure, patients with borderline low blood pressure, or in patients who have a history of hyponatremia, LVP should be limited to 5L.

The amount of volume that can be safely removed during large volume paracentesis (LVP) will depend on the etiology of the patient's ascites, their hemodynamics, and, in the case of decompensated cirrhosis, the severity of their liver disease.

Generally, up to 4-6 L of ascites removed is felt to have ...

There is insufficient literature to show that albumin is required as the fluid is essentially ''outside the body'' and removal should not necessitate albumin at all.