00:00
The refractory
ascites is a ascites
that is unresponsive to
the common treatment.
00:05
So when we try sodium
restriction diet
and a high dose diuretic
and it doesn't work.
00:11
We don't decrease
the amount of ascites
or get it to a manageable level
that's considered
refractory ascites.
00:18
Because it's going to pop right
back up after paracentesis.
00:22
So we try the diet,
we try the diuretics that didn't work.
00:25
We try the paracentesis, we pull off a
fair amount of fluid and then it just
fills right back up
after the paracentesis.
00:34
That's the definition
of refractory ascites
and this has significant
impact on quality of life.
00:40
I'm going to give you an even
better picture way to think
about refractory ascites.
00:46
There's our picture of
ascites the ocean of blue,
you see the tubing that leads
to the drainage container.
00:51
This is a fairly rare occurrence
since less than 10% of
patients with cirrhosis
and ascites develop into liver
refractory ascites, okay.
01:02
So we're talking about a
fairly rare occurrence,
but when it happens,
it's a big deal.
01:08
We've got multiple cups
there to remind you.
01:10
They're putting
out large volumes.
01:13
Let me give you some actual numbers
to understand when I say large volumes
how big I mean?
These patients with
refractory ascites
accumulate as much as 10
to 15 liters of ascites
every 15 days.
01:29
10 to 15 liters every 15 days.
01:31
So just a smidgen
over two weeks.
01:35
You're now carrying around,
seven and a half
two liter bottles of
Diet Mountain Dew worth
of fluid in your abdomen.
01:44
Can you imagine how that would
impact your quality of life.
01:47
Your ability to drive your
ability to walk your energy.
01:51
This is a huge deal to the
patient that's experiencing it.
01:55
So while we may not see
it very often when we do
this requires the whole team
to collaborate and help
the patient deal with it.