Early changes in serum electrolytes and acid–base status with administration of 4 % albumin

Bihari, Shailesh; Prakash, Shivesh; Bersten, Andrew D.

doi:10.1007/s00134-014-3385-6

Cited by 10 publications

(9 citation statements)

References 5 publications

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“…Unlike the findings of Bihari et al [2] who observed a significant decrease in PaO 2 /FiO 2 ratio 1 h after the infusion of 4 % albumin, PaO 2 / FiO 2 ratio remained unchanged after 20 % HAS administration in our study (Table 1).…”

contrasting

confidence: 57%

“…The decline in chloride levels seen in our study is likely a reflection of This can explain the opposite changes observed in chloride levels after the administration of 20 % and 4 % HAS [2], the latter contains higher amounts of chloride. Bruegger et al found a significant decrease in pH after the infusion of 20 % HAS in patients undergoing gynecologic surgery; this decrease was caused by an increase in A -, even though SID also increased to almost the same extent as A - [3].…”

mentioning

confidence: 48%

“…A slight decrease in iCa 2? levels had also been reported 1 h after the administration of 4 % HAS in critically ill patients [2].…”

mentioning

confidence: 99%

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Effects of a rapid infusion of 20 % human serum albumin solution on acid–base status and electrolytes in critically ill patients

et al. 2015

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contrasting

confidence: 57%

mentioning

confidence: 48%

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Effects of a rapid infusion of 20 % human serum albumin solution on acid–base status and electrolytes in critically ill patients

et al. 2015

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“…In the same way, the decline in Ca 2+ concentrations is likely due to binding of free calcium with the infused albumin (both for iso and hyperoncotic) taking into account that albumin solutions have an absence of calcium [83,88].…”

Section: Albumin Effects On Hemostasis: From In Vitro To Clinical Evimentioning

confidence: 99%

“…The effect of albumin infusion in Cllevels depends on the different preparations. The rise in Cllevels seen after 4% albumin infusion is likely a reflection of the larger amounts of Clpresent in the commercial solution (Cl -128 mmol/L), whereas the decline in Cllevels seen after 20% albumin infusion reflects the moderate amounts of Clpresent in the solution (65 mmol/L) [83,88].…”

Section: Albumin Effects On Hemostasis: From In Vitro To Clinical Evimentioning

confidence: 99%

Non-oncotic properties of albumin. A multidisciplinary vision about the implications for critically ill patients

Ferrer

Mateu

Maseda

et al. 2017

Expert Review of Clinical Pharmacology

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Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today's critical care unit is also linked to its multiple pharmacological effects. Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients. Such binding to albumin is frequently lessened in critically ill patients with hypoalbuminemia. These changes could result in sub-optimal treatment. Albumin has immunomodulatory capacity by binding several bacterial products. Albumin also influences vascular integrity, contributing to the maintenance of the normal capillary permeability. Moreover, the albumin molecule encompasses several antioxidant properties, thereby significantly reducing re-oxygenation injury, which is especially important in sepsis. In fact, most studies of albumin administration are a combination of a degree of resuscitation with a degree of maintenance or supplementation of albumin. Expert commentary: The potential clinical benefits of the use of albumin in selected critically ill patients such as sepsis seem related to its immunomodulatory and anti-inflammatory effects, antioxidant properties, antibiotic transportation and endothelial stabilization. Additional studies are warranted to further elucidate the underlying physiologic and molecular rationale.

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Small volume resuscitation with 20% albumin in intensive care: physiological effects

et al. 2018

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Purpose: We set out to assess the resuscitation fluid requirements and physiological and clinical responses of intensive care unit (ICU) patients resuscitated with 20% albumin versus 4-5% albumin. Methods:We performed a randomised controlled trial in 321 adult patients requiring fluid resuscitation within 48 h of admission to three ICUs in Australia and the UK. Results:The cumulative volume of resuscitation fluid at 48 h (primary outcome) was lower in the 20% albumin group than in the 4-5% albumin group [median difference − 600 ml, 95% confidence interval (CI) − 800 to − 400; P < 0.001]. The 20% albumin group had lower cumulative fluid balance at 48 h (mean difference − 576 ml, 95% CI − 1033 to − 119; P = 0.01). Peak albumin levels were higher but sodium and chloride levels lower in the 20% albumin group. Median (interquartile range) duration of mechanical ventilation was 12.0 h (7.6, 33.1) in the 20% albumin group and 15.3 h (7.7, 58.1) in the 4-5% albumin group (P = 0.13); the proportion of patients commenced on renal replacement therapy after randomization was 3.3% and 4.2% (P = 0.67), respectively, and the proportion discharged alive from ICU was 97.4% and 91.1% (P = 0.02). Conclusions:Resuscitation with 20% albumin decreased resuscitation fluid requirements, minimized positive early fluid balance and was not associated with any evidence of harm compared with 4-5% albumin. These findings support the safety of further exploration of resuscitation with 20% albumin in larger randomised trials.

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Early changes in serum electrolytes and acid–base status with administration of 4 % albumin

Cited by 10 publications

References 5 publications

Effects of a rapid infusion of 20 % human serum albumin solution on acid–base status and electrolytes in critically ill patients

Effects of a rapid infusion of 20 % human serum albumin solution on acid–base status and electrolytes in critically ill patients

Non-oncotic properties of albumin. A multidisciplinary vision about the implications for critically ill patients

Small volume resuscitation with 20% albumin in intensive care: physiological effects

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