Effect of Exogenous Albumin Replacement on Plasma Colloid Osmotic Pressure in Severe Preeclampsia: A Case-control Study

Abstract

Background: In preeclampsia, hypoalbuminemia reduces plasma colloid osmotic pressure (PCOP) and favors capillary leakage. Replacement with exogenous albumin is a therapeutic alternative.
 Objective: to determine the effect of exogenous albumin replacement on PCOP in patients with severe preeclampsia (SP).
 Methods: A case-control study was carried out in 76 pregnant patients with SP from the Intensive Care Unit (ICU). The case group (n=38) received 0.9% saline solution 1000 ml every 8 hours and 25% albumin 50 ml every 8 hours and the control group (n=38) only received 0.9% saline solution 1000 ml every 8 hours. Plasma albumin concentrations, PCOP, hemodynamic and laboratory data from admission (baseline measurement) vs discharge from the ICU (final measurement) of both groups were compared.
 Statistical Analysis: the data was analyzed with descriptive statistics, paired Student's t-test and Pearson's correlation coefficient with the statistical program SPSS® version 20. The p value <0.05 was significant.
 Results: A significant decrease in plasma albumin was found (case group 2.72±0.44 vs 2.45±0.48 g/dL, p=0.0141; control group 3.06±0.33 vs 2.58±0.29 g/dL, p=0.0431). PCOP was also significantly reduced (case group 18.44±2.92 vs 16.82±2.70 mmHg, p=0.0210; control group 20.38±2.28 vs 17.46±1.96 mmHg, p=0.0763). The group of cases showed an increase in uresis (p=0.0326), but without changes in central venous pressure (p=0.3246) and serum creatinine (p=0.9515). With this evidence the recommendation is that its use in patients with preeclampsia should be reserved for the experience of the medical team.
 Conclusion: Exogenous albumin replacement therapy did not correct the PCOP values or the blood albumin concentration.