Research Objectives- We hypothesized high-dose 25% albumin would be superior to standard medical treatment in improving 3-month mortality in patients with acute decompensation of cirrhosis by improving the systemic hemodynamics and amelioration of systemic inflammation, endothelial function and coagulation. Aim: To study the efficacy of 25% albumin in reducing 3-month mortality in acute decompensation in cirrhosis. Primary Objective • To study the efficacy of 25% albumin in reducing the 3-month mortality. Secondary Objectives * To study the cumulative incidence of liver related complications (paracentesis induced circulatory dysfunction (PICD), AKI, hyponatremia, hepatic encephalopathy and variceal bleed) * Improvement in MELD, CTP, SOFA and AARC scores * Impact on cardiac function and systemic hemodynamics * Impact of albumin on development of SBP and non-SBP infections * Survival free of liver transplant and TIPS at 3 months * Effect of albumin therapy on immunomodulation, dysfunctional albumin, endothelial function and coagulation at 3 months * Proportion of patients achieving recompensation at 3 months * Time to achieve serum albumin \>4 g/dL and its correlation with clinical outcomes.
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Overall mortality.
Timeframe: 3 months