Paracentesis - Ascites Fluid Analysis
Calculations: ...
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Description

Paracentesis - Ascites Fluid Analysis

Calculations: 

     # of PMNs = Total nucleated cells x % of PMNs

          Correction for RBCs (RBC count > 50,000/mm3, seen in “traumatic tap”) = measured PMNs – (measured RBCs / 250)

     # SAAG = Serum Albumin – Ascitic Fluid Albumin (from samples obtained on the same day)

PMN ≥ 250/µL

    (+) Ascites culture - Spontaneous Bacterial Peritonitis (SBP) (Secondary Peritonitis → polymicrobial)

    (–) Ascites culture - Culture Negative Neutrocytic Ascites (CNNA)

PMN < 250/µL

    (+) Ascites culture - Non-neutrocytic Bacterascites (NNBA)

    (–) Ascites culture - Normal

SAAG ≥ 1.1 g/dL, Serum protein < 2.5 - Cirrhosis

SAAG ≥ 1.1 g/dL, Serum protein > 2.5 - CHF, Budd-Chiari

SAAG < 1.1 g/dL, Serum protein < 2.5 - Nephrotic syndrome

SAAG < 1.1 g/dL, Serum protein > 2.5 - Peritoneal carcinomatosis, TB, Pancreatitis



#Paracentesis #ascites #Interpretation #Fluid #Analysis #differential #diagnosis #table #comparison #hepatology
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Account created for the MGH Internal Medicine Housestaff Manual "White Book" - https://stk10.github.io/MGH-Docs/WhiteBook-2019-2020.pdf
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