Albumin Administration in Acute Ischemic Stroke: Safety Analysis of the ALIAS Part 2 Multicenter Trial

Hill, Michael D.; Martin, Renée; Palesch, Yuko Y.; Moy, C.; Tamariz, Diego; Ryckborst, Karla J; Jones, Elizabeth B.; Weisman, David C.; Pettigrew, L. Creed; Ginsberg, Myron D.

doi:10.1371/journal.pone.0131390

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…Despite the apparent relations between higher SA concentration and better outcome from epidemiologic evidence, active therapy with albumin solution in acute ischemic stroke did not improve the outcome. This was true also for intracerebral hemorrhage and pulmonary edema where increased risk rates were identified [ 54 , 55 ].…”

Section: Serum Albumin and Prognosis In Cardiovascular Diseasementioning

confidence: 95%

Critical appraisal of the role of serum albumin in cardiovascular disease

et al. 2017

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Concentration of serum albumin (SA), a multifunctional circulatory protein, is influenced by several factors, including its synthesis rate, catabolism rate, extravascular distribution, and exogenous loss. Moreover, both nutritional status and systemic inflammation affect the synthesis of SA. Determining SA concentration aids in risk prediction in various clinical settings. It is of interest to understand the prognostic value of SA in the full spectrum of cardiovascular disease (CVD) in the era of newly developed pharmacological and interventional treatments. Proper interpretation of SA in addition to established risk factors potentially provides a better risk discrimination and thereby presents an option to modify therapeutic strategies accordingly. In this narrative review, we summarize the basic features of SA and its associated physiological functions contributing to its prognostic impacts on CVD. Finally, we discuss the prognostic role of SA in CVDs based on existing evidence.

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Section: Serum Albumin and Prognosis In Cardiovascular Diseasementioning

confidence: 95%

Critical appraisal of the role of serum albumin in cardiovascular disease

et al. 2017

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“…55,59,60 Unfortunately, in a large clinical trial of ischemic stroke, high dose IV albumin did not improve outcome, 61 apparently because adverse events balanced out the treatment effect. 62 Preliminary clinical trial data, however, suggest that IV albumin may help prevent delayed cerebral ischemia and cerebral infarction following subarachnoid hemorrhage. 63 Production of Nitric Oxide.-An early event in migraine is activation of eNOS or NOS-3, 64 likely through the 5-HT 2B receptor.…”

Section: Components Of Migraine Through the Lens Of Neuroprotectionmentioning

confidence: 99%

The Migraine Attack as a Homeostatic, Neuroprotective Response to Brain Oxidative Stress: Preliminary Evidence for a Theory

Borkum

2017

Headache

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Background.-Previous research has suggested that migraineurs show higher levels of oxidative stress (lipid peroxides) between migraine attacks and that migraine triggers may further increase brain oxidative stress. Oxidative stress is transduced into a neural signal by the TRPA1 ion channel on meningeal pain receptors, eliciting neurogenic inflammation, a key event in migraine. Thus, migraines may be a response to brain oxidative stress.Results.-In this article, a number of migraine components are considered: cortical spreading depression, platelet activation, plasma protein extravasation, endothelial nitric oxide synthesis, and the release of serotonin, substance P, calcitonin gene-related peptide, and brain-derived neurotrophic factor. Evidence is presented from in vitro research and animal and human studies of ischemia suggesting that each component has neuroprotective functions, decreasing oxidant production, upregulating antioxidant enzymes, stimulating neurogenesis, preventing apoptosis, facilitating mitochondrial biogenesis, and/or releasing growth factors in the brain. Feedback loops between these components are described. Limitations and challenges to the model are discussed.Conclusions.-The theory is presented that migraines are an integrated defensive, neuroprotective response to brain oxidative stress.

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“…There is still great controversy about the use of albumin for resuscitation in shock. Hill et al (19) and Martin et al (20) found that albumin administration increased the risk of pulmonary edema. Compared with crystalloids, most studies have shown that albumin has no effect on the outcome in critically ill patients (5,21) and has no effect on pulmonary edema (22), and many studies have been carried out to further investigate the therapeutic effect of albumin.…”

Section: Discussionmentioning

confidence: 98%

Early Combination of Albumin With Crystalloid Administration Might Reduce Mortality in Patients With Cardiogenic Shock: An Over 10-Year Intensive Care Survey

Zou

Wang

Peng

et al. 2022

Front. Cardiovasc. Med.

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BackgroundIn updated international guidelines, combined albumin resuscitation is recommended for septic shock patients who receive large volumes of crystalloids, but minimal data exist on albumin use and the optimal timing in those with cardiogenic shock (CS). The objective of this study was to evaluate the relationship between resuscitation with a combination of albumin within 24 h and 30-day mortality in CS patients.MethodsWe screened patients with CS from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Multivariable Cox proportional hazards models and propensity score matching (PSM) were employed to explore associations between combined albumin resuscitation within 24 h and 30-day mortality in CS. Models adjusted for CS considered potential confounders. E-value analysis suggested for unmeasured confounding.ResultsWe categorized 1,332 and 254 patients into crystalloid-only and early albumin combination groups, respectively. Patients who received the albumin combination had decreased 30-day and 60-day mortality (21.7 vs. 32.4% and 25.2 vs. 34.2%, respectively, P < 0.001), and the results were robust after PSM (21.3 vs. 44.7% and 24.9 vs. 47.0%, respectively, P < 0.001) and following E-value. Stratified analysis showed that only ≥ 60 years old patients benefited from administration early albumin. In the early albumin combination group, the hazard ratios (HRs) of different adjusted covariates remained significant (HRs of 0.45–0.64, P < 0.05). Subgroup analysis showed that resuscitation with combination albumin was significantly associated with reduced 30-day mortality in patients with maximum sequential organ failure assessment score≥10, with acute myocardial infarction, without an Impella or intra-aortic balloon pump, and with or without furosemide and mechanical ventilation (HRs of 0.49, 0.58, 0.65, 0.40, 0.65 and 0.48, respectively; P < 0.001).ConclusionThis study found, compared with those given crystalloid-only, resuscitation with combination albumin within 24 h is associated with lower 30-day mortality of CS patients aged≥60. The results should be conducted to further assess in randomized controlled trials.

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Albumin Administration in Acute Ischemic Stroke: Safety Analysis of the ALIAS Part 2 Multicenter Trial

Cited by 9 publications

References 27 publications

Critical appraisal of the role of serum albumin in cardiovascular disease

Critical appraisal of the role of serum albumin in cardiovascular disease

The Migraine Attack as a Homeostatic, Neuroprotective Response to Brain Oxidative Stress: Preliminary Evidence for a Theory

Early Combination of Albumin With Crystalloid Administration Might Reduce Mortality in Patients With Cardiogenic Shock: An Over 10-Year Intensive Care Survey

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