IVO BUHAC, M.D.
To the editor: A recent flurry of reports relating disseminated intravascular coagulation to the insertion of LeVeen shunts has prompted thoughts about preventive screening measures in candidates for shunt treatment. The application of a test dose of ascitic fluid 24 h before insertion of the shunt is being advocated. Also, exclusion from shunting of patients with Limulus-lysate-gelation-assay (LLGA)-positive ascitic fluid is proposed (1). In both suggestions the implicit premise is that the dynamics of ascites formation and the composition of ascitic fluid do not change after the peritoneovenous shunt starts functioning.
Some experiences, however, indicate that this assumption might not
BUHAC I. Ascites, the LeVeen Shunt, and Endotoxin. Ann Intern Med. ;92:573. doi: 10.7326/0003-4819-92-4-573_1
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Published: Ann Intern Med. 1980;92(4):573.
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