Published online Aug 28, 2016. doi: 10.4254/wjh.v8.i24.1012
Peer-review started: May 3, 2016
First decision: June 17, 2016
Revised: July 1, 2016
Accepted: July 14, 2016
Article in press: July 18, 2016
Published online: August 28, 2016
Processing time: 117 Days and 9.7 Hours
Non-selective beta blockers (NSBB) are commonly used to prevent portal hypertensive bleeding in cirrhotics. Nevertheless, in the last years, the use of NSBB in critically decompensated patients, especially in those with refractory ascites, has been questioned, mainly for an increased risk of mortality and worsening of systemic hemodynamics. Moreover, even if NSBB have been reported to correlate with a higher risk of renal failure and severe infection in patients with advanced liver disease and hypotension, their use has been associated with a reduction of risk of spontaneous bacterial peritonitis, modification of gut permeability and reduction of bacterial translocation. This manuscript systematically reviews the published evidences about harms and benefits of the use of NSBB in patients with decompensated cirrhosis.
Core tip: In this review, we’ve critically analyzed the recent evidence on the role played by non-selective beta blockers in patients with decompensated liver disease.