Fluid and Electrolyte Management of Ascites in Patients with Cirrhosis

The management and nursing care of cirrhotic ascites

Over 3000 deaths from cirrhosis/chronic liver disease are reported in England and Wales each year. However, these figures may underestimate the true extent of liver-related mortality by between 30-60%. As more patients with advanced cirrhosis are being nursed outside of specialist centres, it is essential that health professionals are aware of the management of cirrhotic-related complications. Defined as fluid within the peritoneal cavity, ascites is one of the most frequent complications of cirrhosis, and is considered as the marker of the transition from compensated to decompensated liver disease. The development of ascites is associated with a poor quality of life, increased risk of infections, renal failure and poor long-term outcomes. In recent years, however, there have been several advances in the management of ascites. This article will discuss both the pathophysiology, and the current medical, surgical and nursing management of this condition.