Effect Of Albumin Infusion Research Articles

Role of Albumin Infusion in Treatment outcome and Preventing DSS in Children with DF: A quasi Experimental Study

Background: Growing number of Dengue patients posed a threat to the community. It also stood with a great deal of challenge to the physicians working in the hospitals and treating the pediatric patients yet looking for a straightforward approach to deal with severe cases of Dengue. Observing the low albumin status in every single Dengue Shock Syndrome (DSS) the concept of arresting the progression of DF (Dengue Fever) to DSS (Dengue Shock Syndrome) came in our mind. Therefore, the study topic was selected as “Role of albumin infusion in treatment outcome and preventing DSS in children with DF: A quasi purposive study.” Objective: The objectives of the study were to observe the status of albumin of DF, the relationship of Albumin with Platelets, the effect of albumin infusion on the progress of DF to DSS. Patients and Methods: This is a prospective quasi purposive study conducted in the department of Pediatrics at Bangladesh Specialized Hospital (BSH) from June 2022 to December 2022 in the age group of Pediatric patients (from more than 1 month eighteen years). All the patients admitted with DF or DSS during that period were included in the study. National Guideline of DF and DSS was followed to Diagnose and to hydrate the Dengue affected children. Albumin was administered to manage not only DSS but also DF children to prevent them from progressing to DSS. Journal of Bangladesh College of Physicians and Surgeons Vol. 41, Dengue Fever Supplement Issue, October 2023 They were managed following the national guideline. Additionally, Hct and Albumin status were closely monitored particularly on day five, six and seven of the disease. Albumin was administered according to the set protocol for this study. Results: A total of 44 cases were included in the study. Among them 28 DF and 16 DSS were diagnosed and documented in this study. Twenty-seven male and seventeen female children were admitted with common symptoms like Fever, bodyache, headache, abdominal pain, vomiting and loose motion. A total of thirty-six children were administered Albumin. Among them 21 were DF and 15 were DSS. In statistical analysis no significant difference was found in Age, Weight, Hematocrit (Hct), Ferritin on admission when compared between DF and DSS. No significant difference could be observed also in Hospital Stay as compared between the two groups. However, significant statistical differences were detected in Day 1, 2, 3 platelet levels and Day 1 and 2 Albumin levels. Neither any DIC nor any MISC, nor any death was recorded. No antibiotic was required. No Platelet transfusion, no IVIG, no Methylprednisolone, nor any other steroid was needed. No significant adverse effect was documented in administering Albumin. Conclusion: In this study it has been found that albumin is safe to use in children with DF to prevent DSS. It also is effective in reducing morbidity in Dengue affected children. J Bangladesh Coll Phys Surg 2023; 41: 51-62

Effectiveness of albumin infusion in the management of hyponatremia in decompensated cirrhosis: a systematic review and meta-analysis

Background and Aim: Hyponatraemia portends a poor prognosis in decompensated cirrhosis and is an independent predictor of mortality. Multiple modalities have been evaluated in the management of hyponatremia, including albumin infusion. However, the effect of albumin infusion in the resolution of hyponatremia is unclear. We conducted a systematic review to explore the available literature on the use of albumin infusion in hyponatremia. Methods: We performed a comprehensive search using MEDLINE and EMBASE for studies reporting the effectiveness of albumin infusion in the resolution of hyponatremia. All available studies on adult patients published in the English language investigating the impact of albumin infusion of any dose, administration frequency, and duration of therapy were included. The study protocol was prospectively registered (CRD42021245914) Results: The literature search yielded 1473 references after duplicate removal. Only four studies (two cohort studies, one case series and one randomized trial) satisfied the predefined selection criteria after a full-text review. While hyponatremia was clearly defined as serum sodium <130meEq/L in all studies, only one study explicitly defined hyponatremia resolution (serum sodium >135mEq/L). No differentiation was made between the type of hyponatremia. The strength of albumin infusion used was 5 % and 20%. All but one study reported significant improvement of hyponatremia with albumin infusion. A subgroup analysis showed albumin infusion improved 30-day survival (Odds ratio 0.43, 95% CI 0.25-0.74, I2=0.) No studies reported adverse events or impact of concomitant associations ( diuretic withawal, lactulose use, sepsis). Conclusion: The available evidence for the use of albumin infusion for the resolution of hyponatremia is insufficient. Large prospective studies with pre-defined selection criteria and endpoints are required to generate the evidence

Hypoalbuminemia in critically sick children.

Context:There is a paucity of data evaluating serum albumin levels and outcome of critically ill-children admitted to intensive care unit (ICU).Aims:The aim was to study frequency of hypoalbuminemia and examine association between hypoalbuminemia and outcome in critically ill-children.Settings and Design:Retrospective review of medical records of 435 patients admitted to 12 bedded pediatric ICU (PICU).Materials and Methods:Patients with hypoalbuminemia on admission or any time during PICU stay were compared with normoalbuminemic patients for demographic and clinical profile. Effect of albumin infusion was also examined. Odds ratio and 95% confidence interval were calculated using SPSS 16.Results:Hypoalbuminemia was present on admission in 21% (92 of 435) patients that increased to 34% at the end of 1st week and to 37% (164 of 435) during rest of the stay in PICU. Hypoalbuminemic patients had higher Pediatric Risk of Mortality scores (12.9 vs. 7.5, P < 0.001) and prolonged PICU stay (13.8 vs. 6.7 days, P < 0.001); higher likelihood of respiratory failure requiring mechanical ventilaton (84.8% vs. 28.8%, P < 0.001), prolonged ventilatory support, progression to multiorgan dysfunction syndrome (87.8% vs. 16.2%) and risk of mortality (25.6% vs. 17.7%). Though, the survivors among recipients of albumin infusion had significantly higher increase in serum albumin level (0.76 g/dL, standard deviation [SD] 0.54) compared with nonsurvivors (0.46 g/dL, SD 0.44; P = 0.016), albumin infusion did not reduce the risk of mortality.Conclusions:Hypoalbuminemia is a significant indicator of mortality and morbidity in critically sick children. More studies are needed to define role of albumin infusion in treatment of such patients.

Effects of albumin infusion on LPS-induced damage of mesenteric microcirculation

Cosenza, L.; Donati, A.; Cecero, E.; Carlucci, M.; Adembri, C.; Fusi, F. Author Information

Effect of albumin infusion on preventing the deterioration of renal function in patients with spontaneous bacterial peritonitis

OBJECTIVE: To determine whether plasma volume expansion with albumin could prevent impairment of renal function and reduce mortality in cirrhotic patients with either acute spontaneous bacterial peritonitis (SBP) or patients complicated with SBP. METHODS: A total of 112 patients was randomly allocated to two groups: 56 patients were allocated to be treated with ceftriaxone and 56 patients were allocated to treatment with ceftriaxone plus intra‐venous albumin in 3 weeks. Serum creatinine and blood urea nitrogen levels were monitored. RESULTS: Of the 56 patients (group 2) treated with ceftriaxone and albumin, five patients had renal impairment. Of the 56 patients (group 1) treated with ceftriaxone alone, 19 had renal impairment. The incidence of renal impairment was significantly lower in patients treated with ceftriaxone and albumin (5/56; 10%) than in patients treated with ceftriaxone alone (19/56; 34%; P = 0.002). In addition, in‐hospital mortality in group 2 was 10% (5/56), but was 33% (17/56) in group 1. Thus, in‐hospital mortality was significantly reduced from 33% (17/56) in patients treated with ceftriaxone to 10% (5/56) in patients treated with ceftriaxone and albumin (P = 0.01). CONCLUSIONS: The addition of intravenous albumin to an antibiotic regimen reduces the incidence of renal impairment and mortality in cirrhotic patients with SBP.

Effect of albumin infusion on response to furosemide in patients with cirrhotic ascites

Effect of albumin infusion on response to furosemide in patients with cirrhotic ascites

Immediate effects of albumin infusion in ill premature neonates.

Ten normotensive premature infants with idiopathic respiratory distress syndrome, and albumin concentrations of less than 30 g/l were given 5 ml/kg of 20% salt poor albumin by infusion. Concentrations measured six hours after infusion had increased significantly and these were associated with significant reduction in weight and improvement in urine output.

Effect of albumin infusion on pulmonary microvascular fluid and protein transport

The effect of human albumin infusion on the dynamics of fluid and protein transport across the pulmonary microcirculation was studied. Lung lymph flow ( Q ̇ L ) from a chronic lung lymph fistula in unanesthetized sheep was used as a reliable indicator of transvascular fluid filtration rate ( Q ̇ L ). Lymph protein content was considered equal to interstitial protein content. Pulmonary vascular pressures, Q ̇ L , lymph and plasma proteins were continuously monitored. After a 4-hr baseline period, 50g of human, salt-poor albumin (400 cc) was infused over 0.5-hr. A hypersensitivity reaction occurred, in four studies, reflected in a large increase in pulmonary artery pressure and Q ̇ L . Mean data for the remaining six studies are summarized for baseline, after albumin infusion and 2 and 4 hr postinfusion. Microvascular pressure ( P mr, mm Hg) for the four periods was 8, 12, 8, and 8, while plasma colloid osmotic pressure ( π mv, mm Hg) was 21, 27, 24, and 24, respectively. Interstitial colloid osmotic pressure ( π mv) was 11, 11, 13, and 14 mm Hg. Q ̇ L was unchanged over the entire study period. We found that albumin infusion produced an immediate increase in plasma oncotic pressure and a transient increase in P mv. However, the colloid osmotic gradient between the interstitium and plasma returned to baseline by 4 hr despite a continued increase in plasma proteins as interstitial protein content increased in an equal manner. These data suggest a very transient, if any, decrease in lung extravascular fluid after albumin infusion.

Morphologic, biochemical and physiologic alterations in a case of idiopathic hypoalbuminemia (analbuminemia)

A patient with idiopathic hypoalbuminemia is described. A study of albumin kinetics demonstrated slowed albumin degradation suggesting low albumin synthesis. Morphologic observation of hepatocellular alterations suggested decreased protein synthesis. The intra- and extravascular space was low with an abnormally large postural shift of intravascular fluid into the extravascular compartment. Disturbances in the concentration of plasma lipids and of several plasma proteins were detected. The effect of albumin infusion on these physiologic and biochemical abnormalities suggests that most occurred as a secondary response to the hypoalbuminemic state. Evaluation of the patient's kindred revealed no members with hypoalbuminemia.

Effect of albumin infusion on renal glucose reabsorption in the rat.

Clearance and micropuncture techniques were employed to assess the relationship between renal glucose and sodium reabsorption in the rat. Late proximal tubular fluid was collected from surface nephrons before and at two intervals after the infusion of hyperoncotic albumin by a double recollection technique. Plasma glucose levels were maintained at 28-44 mM throughout. Proximal tubular reabsorptive rates for both glucose and sodium were elevated 20 min after the start of the hyperoncotic infusion. Continued infusion of the hyperoncotic albumin resulted in a natriuresis and a parallel fall in proximal glucose and sodium reabsorption. Changes in maximal glucose reabsorption rates for the whole kidney paralleled changes in glucose reabsorption in surface nephrons. The addition of calcium and magnesium to the hyperoncotic infusate diminished the natriuresis but did not alter the relationship between sodium and glucose reabsorption. These observations indicate a close relationship between proximal tubular glucose reabsorption and sodium reabsorption during hyperoncotic infusion.