Bhutta et al studied patients in the hospital with cirrhosis and ascites who were being treated with beta-blockers. The authors are from Yale-New Haven Hospital, University of Pennsylvania, University of Alberta, University of Toronto, Baylor University, Virginia Commonwealth University and McGuire VA Medical Center in Richmond.

Patient selection: cirrhosis with ascites, including refractory ascites


Discontinuation of beta-blockers was associated with:

(1) low mean arterial pressure

(2) infection

(3) acute kidney injury (AKI)


Re-initiation prior to discharge with:

(1) increase in mean arterial pressure


The conclusion was that beta-blockers did not need to be discontinued in patients with cirrhosis and ascites unless there was a decrease in the mean arterial pressure. If discontinued it can be reinitiated prior to discharge in many patients.

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