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Albumin: To Use or Not to Use? Contemporary Alternatives?

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Volume Replacement

Abstract

Well balanced plasma volume support is essential in the clinical therapy of critically ill patients and patients undergoing elective or acute surgical procedures. The main objectives of the volume support are to maintain/achieve normovolaemia, haemodynamic stability, and adequate microvascular blood flow. An optimal fluid regimen should not include any obvious risk of excessive increases in tissue hydration, whereby microvascular blood flow may be jeopardized due to oedema induced compression of capillaries. The infusion of vast quantities of balanced salt solutions for plasma volume support may include such disadvantages due to the poor intravascular retention of a crystalloid [1]. When colloid containing solutions are infused, the presence of oncotically active macromolecules, which do not easily cross capillary membranes, will considerably reduce the total fluid volume requirements for adequate plasma volume support [1]. Therefore, plasma volume replacement with colloids is usually advantageous in many clinical situations [1, 2].

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References

  1. Haljamäe H (1996) Crystalloids vs colloids. In: Risberg B (ed) Trauma care — an update. PR-Offset AB, Mölndal, Sweden, pp 129–41

    Google Scholar 

  2. Haljamäe H, Dahlqvist M, Walentin F (1997) Artificial colloids in clinical practice: pros and cons. Baillière’s Clin Anaesthesiol 11:49–79

    Article  Google Scholar 

  3. Grootendorst AF, van Wilgenburg AGM, de Laat PHJM, van der Hoven B (1988) Albumin abuse in intensive care medicine. Intensive Care Med 14:554–447

    Article  PubMed  CAS  Google Scholar 

  4. Erstad BL, Gales BJ, Rappaport WD (1991) The use of albumin in cHnical practice. Arch Intern Med 151:901–911

    Article  PubMed  CAS  Google Scholar 

  5. Blackburn GL, Driscoll DF (1992) Time to abandon routine albumin supplementation. Editorial. Crit Care Med 20:157–158

    Article  PubMed  CAS  Google Scholar 

  6. Rothschild MA, Oratz M, Schreiber SS (1972) Albumin synthesis. N Engl J Med 286:748–756

    Article  PubMed  CAS  Google Scholar 

  7. Lewis RT (1980) Albumin: role and discriminative use in surgery. Can J Surg 23:322–328

    PubMed  CAS  Google Scholar 

  8. Tullis JL (1977) Albumin. I. Background and use. JAMA 237:355–360

    Article  PubMed  CAS  Google Scholar 

  9. Emerson Jr TE (1989) Unique features of albumin: a brief review. Crit Care Med 17:690–694

    Article  PubMed  Google Scholar 

  10. Allen SJ, Drake RE, Williams JP, Laine GA, Gabel JC (1987) Recent advances in pulmonary edema. Crit Care Med 15:963–970

    Article  PubMed  CAS  Google Scholar 

  11. Oppenheimer L (1990) Lung fluid movement and its relevance to the management of patients with increased lung water. Clin Intens Care 1:103–110

    Google Scholar 

  12. Zarins CK, Rice CL, Peters RM, Virgilio RW (1978) Lymph and pulmonary responses to isobaric reduction in plasma oncotic pressure in baboons. Circul Res 43:925–930

    CAS  Google Scholar 

  13. Oppenheimer L (1990) Lung fluid movement and its relevance to the management of patients with increased lung water. Clin Intens Care 1:103–110

    Google Scholar 

  14. Morissette M, Weil MH, Shubin H (1975) Reduction in colloid osmotic pressure associated with fatal progression of cardiopulmonary failure. Crit Care Med 3:115–117

    Article  PubMed  CAS  Google Scholar 

  15. Foley EF, Borlase BC, Dzik WH, Bistrian BR, Bendotti PN (1990) Albumin supplementation in the critically ill. A prospective, randomized trial. Arch Surg 125:739–742

    Article  PubMed  CAS  Google Scholar 

  16. Wojtysiak SL, Brown RO, Robertson D, Powers DA, Kudsk KA (1992) Effect of hypoalbuminemia and parenteral nutrition on free water excretion and electrolyte-free water resorption. Crit Care Med 20:164–169

    Article  PubMed  CAS  Google Scholar 

  17. Marik PE (1993) The treatment of hypoalbuminemia in the critically ill patient. Heart Lung 22:166–170

    PubMed  CAS  Google Scholar 

  18. Knaus WA, Wagner DP, Draper EA, et al. (1991) The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 100:1619–1636

    Article  PubMed  CAS  Google Scholar 

  19. Holt M, Ryall M, Campell A (1984) Albumin inhibits human polymorphonuclear leucocyte luminol dependent chemilumminescence: evidence for oxygen scavenging. Br J Exp Pathol 65:231–241

    PubMed  CAS  Google Scholar 

  20. Jørgensen KA, Stoffersen E (1979) Heparin like activity of albumin. Thromb Res 16:573–578

    Article  Google Scholar 

  21. Jørgensen KA, Stoffersen E (1980) On the inhibitory effect of albumin on platelet aggregation. Thromb Res 17:13–18

    Article  PubMed  Google Scholar 

  22. Lucas CE, Ledgerwood AM, Mammen EF (1982) Altered coagulation protein content after albumin resuscitation. Ann Surg 196:198–202

    Article  PubMed  CAS  Google Scholar 

  23. Lucas CE, Ledgerwood AM, Higgins RF (1979) Impaired salt and water excretion after albumin resuscitation for hypovolemic shock. Surgery 86:544–549

    PubMed  CAS  Google Scholar 

  24. Lucas CE, Ledgerwood AM, Higgins RF, Weaver DW (1980) Impaired pulmonary function after albumin resuscitation from shock. J Trauma 20:446–451

    Article  PubMed  CAS  Google Scholar 

  25. Lucas CE, Weaver D, Higgins RF, Ledgerwood AM, Johnson SD, Bouwman DL (1978) Effects of albumin versus non-albumin resuscitation on plamsa volume and renal excretory function. J Trauma 18:564–570

    Article  PubMed  CAS  Google Scholar 

  26. Dahn MS, Lucas CE, Ledgerwood AM, Higgins RF (1979) Negative inotropic effect of albumin resuscitation for shock. Surgery 86:235–241

    PubMed  CAS  Google Scholar 

  27. Layon AJ, Gallagher TJ (1990) Five percent human albumin in lactated Ringer’s solution for resuscitation from hemorrhagic shock: Efficacy and cardiopulmonary consequences. Crit Care Med 18:410–413

    Article  PubMed  CAS  Google Scholar 

  28. Stockwell MA, Riley B (1992) Colloid solutions in the critically ill. A randomised comparison of albumin and polygeline. I. Outcome and duration of stay in the intensive care unit. Anaesthesia 47:3–6

    Article  PubMed  CAS  Google Scholar 

  29. Lamke L-O, Liljedahl S-O (1976) Plasma volume changes after infusion of various plasma expanders. Resuscitation 5:93–102

    Article  PubMed  CAS  Google Scholar 

  30. Shoemaker WC, Schluchter M, Hopkins JA, Appel PL, Schwartz S, Chang PC (1981) Comparison of the relative effectiveness of colloids and crystalloids in emergency resuscitation. Am J Surg 142:73–81

    Article  PubMed  CAS  Google Scholar 

  31. Rackow EC, Falk JL, Fein A, et al. (1983) Fluid resuscitation in circulatory shock: a comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemia and septic shock. Crit Care Med 11:839–850

    Article  PubMed  CAS  Google Scholar 

  32. Golub R, Sorrento Jr JJ, Cantu Jr R, Nierman DM, Moideen A, Stein HD

    Google Scholar 

  33. (1994) Efficacy of albumin supplementation in surgical intensive care unit: A prospective, randomized study. Crit Care Med 22:613–619

    Google Scholar 

  34. Alexander MR, Stumpf JL, Nostrant TT, Khanderia U, Eckhauser FE, Colvin CL (1989) Albumin utilization in a university hospital. Ann Pharmacother 23:214–217

    CAS  Google Scholar 

  35. Yim JM, Vermeulen LC, Erstad BL, Matuszewski KA, Burnett DA, Vlasses PH (1995) Albumin and nonprotein colloid solution use in US academic health centers. Arch Intern Med 155:2450–2455

    Article  PubMed  CAS  Google Scholar 

  36. De Gaudio AR (1995) Therapeutic use of albumin. Int J Artif Organs 18:216–224

    PubMed  Google Scholar 

  37. Shippy CR, Shoemaker WC (1983) Hemodynamic and colloid osmotic pressure alterations in the surgical patient. Crit Care Med 11:191–195

    Article  PubMed  CAS  Google Scholar 

  38. Blanloeil Y, Leteurnier Y, Francois T (1996). Indications and role of albumin for vascular loading during postoperative intensive care. Ann Fr Anesth Reanim 15:497–506

    PubMed  CAS  Google Scholar 

  39. Subcommittee of the Victorian Drug Usage Advisory Committee (1992) Human albumin solutions: consensus statements for use in selected clinical situations. Med J Aust 157:340–343

    Google Scholar 

  40. Nicholls MD, Whyte G (1993) Red cell, plasma and albumin transfusion decision triggers. Anaesth Intens Care 21:156–162

    CAS  Google Scholar 

  41. Vermeulen LC, Ratko TA, Erstad BL, Brecher ME, Matuszewski MS (1995) A paradigm for consensus. The university hospital consortium guidelines for the use of albumin, nonprotein colloid, and crystalloid solutions. Arch Intern Med 155:373–379

    Article  PubMed  Google Scholar 

  42. Durand-Zaleski I, Bonnet F, Rochant H, Bierling P, Lemaire F (1992) Usefulness of consensus conferences: the case of albumin. Lancet 340:1388–1390

    Article  PubMed  CAS  Google Scholar 

  43. Beards SC, Watt T, Edwards JD, Nightingale P, Farragher EB (1994) Comparison of the hemodynamic and oxygen transport responsen to modified fluid gelatin and hetastarch in critically ill patients: A prospective, randomized trial. Crit Care Med 22:600–605

    Article  PubMed  CAS  Google Scholar 

  44. Østgaard G, Onarheim H (1996) Retention and distribution of polygeline (Haemaccel) in the rat. Acta Anaesthesiol Scand 40:96–101

    Article  PubMed  Google Scholar 

  45. Haljamäe H (1985) Pathophysiology of shock-induced disturbances in tissue homeostasis. Acta Anaesthesiol Scand 29, Suppl. 82:38–44

    Article  Google Scholar 

  46. Arfors K-E, Buckley PB (1989) Role of artificial colloids in rational fluid therapy. In: Tuma RF, White JV, Messmer K (eds). The role of hemodilu-tion in optimal patient care. München. Zuckswerdt, pp 100–123

    Google Scholar 

  47. Brückner UB, Messmer K (1991) Organ perfusion and tissue oxygenation after moderate isovolemic hemodilution with HES 200/0.62 and dextran-70. Anaesthetist 40:434–440

    Google Scholar 

  48. Le Veen HH, Ip M, Ahmed N, Mascardo T, Guinto RB, Falk G, D’Ovidio N (1980) Lowering blood viscosity to overcome vascular resistance. Surg Gynecol Obstet 150:139–149

    Google Scholar 

  49. Kouraklis G, Sechas M, Skalkeas G (1989) Effects of hemodilution on peripheral circulation. Vase Surg 23:20–26

    Google Scholar 

  50. Brückner UB, Messmer K (1990) Blood rheology and systemic oxygen transport. Biorheology 27:903–912

    PubMed  Google Scholar 

  51. Krieter H, Brückner UB, Kefalianakis F, Messmer K (1995) Does colloid-induced hyperviscosity in haemodilution jeopardize perfusion and oxygenation in vital organs? Acta Aneasthesiol Scand 39:236–244

    Article  CAS  Google Scholar 

  52. Goto Y, Sakakura S, Hatta M, Sugiura Y, Kato T (1985) Hemorheologic effects of colloidal plasma substitutes infusion. A comparative study. Acta Anaesthesiol Scand 29:217–223

    Article  PubMed  CAS  Google Scholar 

  53. Bergqvist D, Bergentz S-E (1983) The role of dextran in severe ischemic extremity disease and arterial reconstructive surgery. VASA 12:213–218

    PubMed  CAS  Google Scholar 

  54. Baldwin AL, Wu NZ, Stein DL (1991) Endothelial surface charge of interstitial mucosal capillaries and its modulation by dextran. Microvasc Res 42:160–178

    Article  PubMed  CAS  Google Scholar 

  55. Nolte D, Illner A, Menger MD, Messmer K (1992) Reduction of postishemic leukocyte-endothelium interaction by dextran 70 but not hydro-xyethylstarch 200/0.62. Int J Microcirc: Clin Exp 11:203–226

    Google Scholar 

  56. Collis RE, Collins PW, Gutteridge CN et al. (1994) The effect of hydroxyethyl starch and other plasma volume substitutes on endothelial cell activation an in vitro study. Intensive Care Med 20:37–41

    Article  PubMed  CAS  Google Scholar 

  57. Strauss RG (1988) Volume replacement and coagulation: A comparative review. J Cardiothorac Anesth 2, Suppl. 1:24–32

    Article  Google Scholar 

  58. Nearman HS, Herman ML (1991) Toxic effects of colloids in the intensive care unit. Crit Care Clin 7:713–723

    PubMed  CAS  Google Scholar 

  59. Bergman A, Andreen M, Blombäck M (1990) Plamsa substitution with 3% dextran-60 in orthopaedic surgery: influence on plasma colloid osmotic pressure, coagulation parameters, immunoglobulins and other plasma constituents. Acta Anaesthesiol Scand 34:21–29

    Article  PubMed  CAS  Google Scholar 

  60. Matthiasson SE, Lindblad B, Mätzsch T, Molin J, Qvarfordt P, Bergqvist D (1994) Study of the interaction of dextran and enoxaparin on haemostasis in humans. Thromb Haemost 72:722–727

    PubMed  CAS  Google Scholar 

  61. Claes Y, Hemelrijck JV, Van Gerven M, et al. (1992) Influence of hydro-xyethyl starch on coagulation in patients during the perioperative period. Anesth Analg 75:24–30

    Article  PubMed  CAS  Google Scholar 

  62. Boldt J, Knothe C, Zickmann B, Andres P, Dapper F, Hempelmann G (1993) Influence of different intravascular volume therapies on platelet function in patients undergoing cardiopulmonary bypass. Anesth Analg 76:1185–1190

    PubMed  CAS  Google Scholar 

  63. Strauss RG, Stump DC, Henriksen RA (1985) Hydroxyethyl starch accentuates von Willebrand’s disease. Transfusion 25:235–237

    Article  PubMed  CAS  Google Scholar 

  64. Sanfelippo MJ, Suberviola PD, Geimer NF (1987) Development of a von Willebrand-like syndrome after prolonged use of hydroxyethyl starch. Am J Clin Pathol 88:653–655

    PubMed  CAS  Google Scholar 

  65. Strauss RG, Stansfield C, Henriksen RA, Villhauer PJ (1988) Pentastarch may cause fewer effects on coagulation than hetastarch. Transfusion 28:257–260

    Article  PubMed  CAS  Google Scholar 

  66. Kapiotis S, Quehenberger P, Eichler H-G et al. (1994) Effect of hydroxyethyl starch on the activity of blood coagulation and fibrinolysis in healthy volunteers: Comparison with albumin. Crit Care Med 22:606–612

    Article  PubMed  CAS  Google Scholar 

  67. Mortelmans YJ, Vermaut G, Verbruggen AM, et al. (1995) Effects of 6% hydroxyethyl starch and 3% modified fluid gelatin on intravascular volume and coagulation during intraoperative hemodilution. Anesth Analg 81:1235–1242

    PubMed  CAS  Google Scholar 

  68. Watkins J (1994) Reactions to gelatin plasma expanders. Letter to the editor. Lancet 344:328–329

    Article  PubMed  CAS  Google Scholar 

  69. Ljungström K-G (1997) Colloid safety: fact and fiction. Baillière’s Clin Anaesthesiol 11:163–177

    Article  Google Scholar 

  70. Lorenz W, Duda D, Dick W, et al. (1994) Incidence and clinical importance of perioperative histamine release: randomized study of volume loading and antihistamines after induction of anaesthesia. Lancet 343:933–940

    Article  PubMed  CAS  Google Scholar 

  71. Watkins J (1991) Allergic and Pseudoallergic reactions to colloid plasma substitutes. Which colloid? Care Crit Ill 7:213–217

    Google Scholar 

  72. Lorenz W, Doenicke A, Messmer K, et al. (1976) Histamin release in human subjects by modified gelatin (haemaccel) and dextran: An explanation for anaphylactoid reactions observed under clinical conditions? Br J Anaesth 48:151–165

    Article  PubMed  CAS  Google Scholar 

  73. Freeman MK (1979) Fatal reaction to haemaccel. Anaesthesia 34:341–343

    Article  PubMed  CAS  Google Scholar 

  74. Watkins J (1994) Reactions to gelatin plasma expanders. Letter to the editor. Lancet 344:328–329

    Article  PubMed  CAS  Google Scholar 

  75. Kraft D, Sirtl C, Laubenthal H, et al. (1992) No evidence for the existance of preformed antibodies against hydroxyethyl starch in man. Eur Surg Res 24:138–142

    Article  PubMed  CAS  Google Scholar 

  76. Porter SS, Goldberg RJ (1986) Intraoperative allergic reactions to hydroxyethyl starch: a report of two cases. Can Anaesth Soc J 33:394–398

    Article  PubMed  CAS  Google Scholar 

  77. Kreimeier U, Christ F, Kraft D, et al. (1995) Anaphylaxis due to hydroxyethyl-starch-reactive antibodies. Lancet 346:49–50

    Article  PubMed  CAS  Google Scholar 

  78. Parker NE, Porter JB, Williams HJM, Leftley N (1982) Pruritus after administration of hetastarch. Br Med J 284:385–386

    Article  CAS  Google Scholar 

  79. Jurecka W, Szépfalusi Z, Parth E, et al. (1993) Hydroxyethylstarch deposits in human skin — a model for pruritus? Arch Dermatol Res 285:13–19

    Article  PubMed  CAS  Google Scholar 

  80. Richter AW, Hedin HI (1982) Dextran hypersensitivity. Immunol Today 3:132–138

    Article  Google Scholar 

  81. Laxenaire MC, Charpentier C, Feldman L, et al. (1994) Anaphylactoid reactions to colloid plasma substitutes: Frequency, risk factors and mechansisms. Ann Fr Anesth Réanim 13:301–310

    PubMed  CAS  Google Scholar 

  82. Kraft D, Hedin H, Richter W, Scheiner O, Rumpold H, Devey M (1982) Immunoglobulin class and subclass distribution of dextran-reactive antibodies in human reactors and non-reactors to clinical dextran. Allergy 37:481–489

    Article  PubMed  CAS  Google Scholar 

  83. Hedin H, Richter W (1982) Pathomechanisms of dextran-induced anaphylactoid/anaphylactic reactions in man. Int Archs Allergy Appl Immun 68:122–126

    Article  CAS  Google Scholar 

  84. Ljungström K-G, Renck H, Hedin H, Richter W, Wiholm B-E (1988) Hapten inhibition and dextran anaphylaxis. Anaesthesia 43:729–732

    Article  PubMed  Google Scholar 

  85. Ljungström KG, Willman B, Hedin H (1993) Hapten inhibition of dextran anaphylaxis. Nine years of post-marketing surveillance of dextran 1. Ann Fr Réanim 12:219–222

    Google Scholar 

  86. Ljungström K-G (1993) Safety of dextran in relation to other colloids — ten years experience with hapten inhibition. Infusionsther Transfusionsmed 20:206–210

    PubMed  Google Scholar 

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  1. H. Haljamäe
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Editors and Affiliations

  1. Anesthesie-Reanimation, Université Pierre et Marie Curie Paris VI, 96, rue Didot, 75014, Paris, France

    Jean-Francois Baron

  2. Neurologische Klinik, Universitätskliniken des Saarlandes, Kirrbergerstraße, 66421, Homburg/Saar, Germany

    Johannes Treib

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Haljamäe, H. (1998). Albumin: To Use or Not to Use? Contemporary Alternatives?. In: Baron, JF., Treib, J. (eds) Volume Replacement. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72170-0_1

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  • DOI: https://doi.org/10.1007/978-3-642-72170-0_1

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  • Print ISBN: 978-3-540-64187-2

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