What are the guideline sources, guidelines and references for Hepatic hydrothorax ?
Guideline sources The following summarized guidelines for the evaluation and management of hepatic hydrothorax are prepared by our editorial team based on guidelines from the American Association for the Study of Liver Diseases (AASLD 2021), the British Association for the Study of the Liver (BASL/BSG 2021), and the European Association for the Study of the Liver (EASL 2010). 1 2 3 Guidelines 1. Diagnostic procedures Diagnostic thoracocentesis: perform a diagnostic thoracocentesis in patients with suspected spontaneous bacterial empyema with inoculation of fluid into blood culture bottles. A 2. Medical management Diuretic therapy: initiate diuretics as first-line therapy in patients with hepatic hydrothorax. E 3. Nonpharmacologic interventions https://web.pathway.md/diseases/recdXbU8zPfHX7Q3O 1/3 6/24/23, 12:41 PM Hepatic hydrothorax Pathway Salt restriction: advise dietary sodium restriction as first-line therapy in patients with hepatic hydrothorax. E 4. Therapeutic procedures Therapeutic thoracocentesis: perform thoracentesis as required in the initial treatment of patients with hepatic hydrothorax. E Percutaneous drainage: avoid inserting a chest tube for hepatic hydrothorax. Consider inserting indwelling tunneled catheters in carefully selected patients not responding to medical therapy and being candidates for TIPS. D Transjugular intrahepatic portosystemic shunt: As per AASLD 2021 guidelines, consider performing TIPS placement in selected patients as second-line therapy for refractory hepatic hydrothorax. E As per BSG 2021 guidelines: Consider performing TIPS placement in patients with hepatic hydrothorax, after discussion with the multidisciplinary team. B Consider offering alternative palliative interventions in patients with hepatic hydrothorax not undergoing TIPS placement and/or liver transplant evaluation. B As per EASL 2010 guidelines, consider TIPS placement in selected patients with recurrent symptomatic hepatic hydrothorax. C 5. Surgical interventions Liver transplantation: consider performing liver transplantation in patients with hepatic hydrothorax. E 6. Specific circumstances Patients with spontaneous bacterial empyema: manage spontaneous bacterial empyema similarly as SBP. References 1. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010 Sep;53 3 397 417. Open 2. Scott W Biggins, Paulo Angeli, Guadalupe Garcia-Tsao et al. Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021 Aug;74 2 1014 1048. Open https://web.pathway.md/diseases/recdXbU8zPfHX7Q3O 2/3 6/24/23, 12:41 PM Hepatic hydrothorax Pathway 3. Guruprasad P Aithal, Naaventhan Palaniyappan, Louise China et al. Guidelines on the management of ascites in cirrhosis. Gut. 2021 Jan;70 1 9 29. Open 4. European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018 Aug;69 2 406 460. Open 5. Ricardo Badillo, Don C Rockey. Hepatic hydrothorax: clinical features, management, and outcomes in 77 patients and review of the literature. Medicine Baltimore). 2014 May;93 3 135 142. Open 6. Yong Lv, Guohong Han, Daiming Fan. Hepatic Hydrothorax. Ann Hepatol. January-February 2018;17 1 33 46. Open 7. Salim R Surani, Yamely Mendez, Humayun Anjum et al. Pulmonary complications of hepatic diseases. World J Gastroenterol. 2016 Jul 14;22 26 6008 15. Open https://web.pathway.md/diseases/recdXbU8zPfHX7Q3O 3/3