203 Palliative Paracentesis In The Home-Care Setting. Results Of A 2-Year Study

Farinas Balaguer Oscar, PADES St Feliu de Llobregat. ICS - Family physician
Adell, Josefina – nurse
Garcia, Natalia – nurse
Gomez, nto dia social worker
Introduction: Patients with advanced oncological and with chronic liver diseases often have severe ascites. Home-care units can perform therapeutical removal of ascitic fluid.
This approach has important advantages for palliative patients
· Improves the quality of medical care: promoting a simple and safe procedure avoiding hospital admission.
· Improvement of patient"s quality of life: sparing patients in poor performance status to move to the hospital
· Reduction of costs.
Aims: To describe the activity of a home-care paracentesis protocol during a two-year period.
Design and Methods: Descriptive retrospective study. Primary palliative care Unit in a rural and urban area. There were entry and exclusion criteria for including patients in the protocol. The procedure was described step by step. All the paracentesis were registered in a data-base with the following items: number of patients, number of extractions, diagnosis, success ratio, events.
Results: Twelve patients were considered, one refused the procedure and another was excluded for thrombocytopenia. Nineteen paracentesis were done.
Patient Diagnosis Extractions Success ratio
1 Hepato Ca 1 1/1
2 Peritoneal Ca 2 3/3
3 Hepato Ca 1 0/1
4 Hepato Ca 1 1/1
5 Hepatic M1 5 5/5
6 Cirrhosis 1 1/1
7 Cirrhosis 5 5/5
8 Cirrhosis 1 1/1
9 Hepatic M1 1 1/1
10 Hepato Ca 1 1/1
Conclusions: Domiciliary paracentesis in palliative patients with cancer and chronic liver diseases is safe and can improve quality of life. In our experience, patients most benefiting from this procedure are those with liver carcinoma and cirrhosis.
Palliative Paracentesis in the Home-care setting. Results of a 2-year study