Thirteen patients with cirrhosis and tense ascites (six with and seven without peripheral edema) underwent 4to 16-liter paracentesis without intravenous "colloid" replacement. Cardiac output increased from 6.6 f 0.7 liters per min at baseline to 8.2 f 0.7 liters per rnin (p c 0.003) 1 hr after large-volume paracentesie completion and fell to 7.5 f 0.69 liters per rnin (p c 0.05 vs. baseline, p c 0.02 vs. 1 hr) 24 hr after large-volume paracentesis completion. There was no change in mean arterial pressure or mean pulmonary artery pressure. Central venous preseure fell from 9.1 f 0.8 mm Hg at baseline to 8.6 f 1.4 mm Hg 1 hr post-large-volume paracentesis to 6.8 f 1.0 mm Hg (p c 0.006 vs. baseline, p c 0.02 vs. 1 hr value) at 24 hr, and pulmonary capillary wedge preseure fell from 13.1 2 0.9 to 11.1 f 1.3 mm Eg 1 h r after large-volume paracentesis and to 9.89 f 1.2 (p c 0.01 vs. baseline, p c 0.03 vs. 1 hr after large-volume paracentesis) at 24 hr. Heart rate fell from 90 f 3.0 to 86 f 2.9 beats per rnin (p c 0.01) 1 hr after large-volume paracentesis completion, but increased to 89 k 2.6 beats per rnin (p c 0.02 vs. 1 hr after largevolume paracentesis) at 24 hr. Blood urea nitrogen fell from 13.3 f 1.8 to 11.7 f 1.6 mg per dl (p c 0.004) 1 hr after large-volume paracentesis, but was unchanged at 24 and 48 hr after large-volume paracentesis. Serum creatinine did not change during the study, but creati- nine clearance fell from 77 f 12.0 ml per min at baseline to 67 t 7.0 ml per rnin (p < 0.06 vs. baseline) 24 hr after large-volume paracentesis and to 60 f 7.5 ml per min (p c 0.05 vs. baseline) 48 hr after large-volume paracentesis. Serum sodium concentration at baseline was 135 f 1.2 d q per liter; 1 hr after large-volume paracentesis decreased to 133 f 1.5 mEq per liter (p c 0.03); and at 48 hr was 132 f 2.1 mEq per liter (p c 0.03). Serum aldaeterone fell from 59.3 f 17.0 to 41 f 12 ng per dl 1 h r after large-volume paracentesis (p < 0.05).
but increased to 59 f 17.0 mg per dl (p c 0.05 vs. 1 hr after large-volume paracentesis) at 24 hr. Plasma renin activity did not change at 1 hr, but increased from