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Paracentesis if coagulopathic

  • Coagulation studies are NOT required before performance of the procedure[1]
  • No data supports cutoff values beyond which paracent should be avoided/prophylactically transfused
  • Routine use of FFP and platelets is not recommended
  • Contraindicated if the patient is actively bleeding or in DIC and the incidence of clinically significant bleeding complications is low even if in liver failure with an elevated INR (< 0.2%)[2]
  1. Wilkerson, Annals of Emerg Med, 2009
  2. Thomsen TW. Paracentesis. N Engl J Med 2006; 355: e21