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Recruitment of extravascular fluid by hyperoncotic albumin
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland.
Sodertalje Hosp, Sweden; Karolinska Inst, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
2018 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 62, no 9, p. 1255-1260Article in journal (Refereed) Published
Abstract [en]

BackgroundAlthough hyperoncotic albumin may be used to recruit oedema, its effectiveness remains unclear. Therefore, this issue was studied during infusion experiments in healthy volunteers. MethodFifteen healthy volunteers (mean age 31years) received an infusion of 3mL/kg of 20% albumin over 30minutes. Their urinary excretion was recorded, and venous blood samples were taken to measure blood haemoglobin (Hb), haematocrit, colloid osmotic pressure as well as plasma albumin and sodium concentrations on 15 occasions over a period of 300minutes. Plasma volume expansion was taken as the inverse of the fluid-induced dilution of venous plasma, as given by the blood Hb concentration. Mass balance calculations were used to estimate the mobilisation of fluid from the tissues. ResultsMaximum plasma volume expansion was reached 20minutes after completing an infusion of 20% albumin. Urinary excretion was effectively increased, and the mobilised fluid from the tissues at 300minutes amounted to 3.41.2mL for each infused mL of 20% albumin, of which 19% was of intracellular origin. The urinary excretion correlated strongly with the amount of recruited fluid (R-2=0.87) and inversely with the plasma volume expansion (R-2=0.53). ConclusionThe infusion of 20% albumin significantly increases the plasma volume by recruiting interstitial fluid. After completing the infusion, there is a delay of 20minutes until maximum plasma dilution is reached, and the duration of the plasma volume expansion lasts far beyond 5hours.

Place, publisher, year, edition, pages
WILEY , 2018. Vol. 62, no 9, p. 1255-1260
Keywords [en]
albumin; fluid recruitment; mass balance; oedema
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:liu:diva-151469DOI: 10.1111/aas.13150ISI: 000443673500010PubMedID: 29845612OAI: oai:DiVA.org:liu-151469DiVA, id: diva2:1250699
Note

Funding Agencies|ALF Grants, Region Ostergotland

Available from: 2018-09-24 Created: 2018-09-24 Last updated: 2019-04-12

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Zdolsek, MarkusZdolsek, Joachim
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Department of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesLocal Health Care Services in East ÖstergötlandDivision of Drug ResearchDepartment of Anaesthesiology and Intensive Care in Linköping
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Acta Anaesthesiologica Scandinavica
Anesthesiology and Intensive Care

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