HIGHLIGHTS
•The use of NSBB in cirrhotic patients with refractory ascites is questioned due to divergent evidence between studies.
•This article aims to gather current evidence on the use of NSBB in this subgroup of patients, evaluating their outcomes.
•Clinical judgment, together with hemodynamic parameters, remains the main definers of the maintenance of these medications.
ABSTRACT
Background:
The established use of non-selective beta-blockers (NSBB) in the primary and secondary prevention of esophageal varices has recently been questioned in the subgroup of patients with diuretic-refractory ascites.
Objective:
Critically analyze the body of evidence on the topic in order to assist clinical decisions.
Methods:
A literature review was carried out in the Pubmed® and Scielo® databases. In total, 20 articles between 2010 and 2023 were read by independent researchers.
Conclusion:
It remains doubtful whether the use of NSBB is deleterious in cirrhotic patients with refractory ascites, however our literature review allows us to conclude that these drugs should not be proscribed in these patients. On the contrary, a doctor-patient decision based on tolerability and hemodynamic parameters certainly seems to be a safe conduct.
Keywords:
Non-selective beta-blockers; refractory ascites; mortality