Incidence And Outcome Of Paracentesis Induced Circulatory Dysfunction In Acute-On-Chronic Liver Failure.

Inclusion Criteria: 1. All patients with acute hepatic insult manifesting as jaundice (Sr. Bil. ≥ 5 mg/dL) and coagulopathy (INR≥1.5), complicated within 4 weeks by ascites and/or encephalopathy in a patient with previously diagnosed or undiagnosed chronic liver disease (ACLF) admitted in the hospital. 2. All Cirrhotics decompensated with ascites admitted in the hospital. 3. Grade II/III ascites 4. Need for paracentesis. Exclusion Criteria: 1. Age \<12 or \> 75 years 2. Hepatocellular carcinoma 3. Non cirrhotic ascites such as malignancy or tubercular peritonitis 4. Serum Cr \>1.5mg% 5. Refractory septic shock 6. Grade III/IV hepatic encephalopathy 7. Abdominal wall cellulitis 8. Active variceal bleed 9. Respiratory, cardiac and renal failure 10. Refusal to participate in the study