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Fluid volume kinetics of 20% albumin
Sodertalje Hosp, Sweden; Karolinska Inst, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
Karolinska Univ Hosp, 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 (ANOPIVA).
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2019 (English)In: British Journal of Clinical Pharmacology, ISSN 0306-5251, E-ISSN 1365-2125, Vol. 85, no 6, p. 1303-1311Article in journal (Refereed) Published
Abstract [en]

Aims A population kinetic model was developed for the body fluid shifts occurring when 20% albumin is given by intravenous infusion. The aim was to study whether its efficacy to expand the plasma volume is impaired after major surgery. Methods An intravenous infusion of 3 mL/kg 20% albumin over 30 minutes was given to 15 volunteers and to 15 patients on the 1(st) day after major open abdominal surgery. Blood samples and urine were collected during 5 hours. Mixed-effect modelling software was used to develop a fluid volume kinetic model, using blood haemoglobin and urine excretion the estimate body fluid shifts, to which individual-specific covariates were added in sequence. Results The rise in plasma albumin expanded the plasma volume in excess of the infused volume by relocating noncirculating fluid (rate constant k(21)), but it also increased losses of fluid from the kinetic system (k(b)). The balance between k(21) and k(b) maintained the rise in plasma albumin and plasma volume at a virtual steady-state for almost 2 hours. The rate constant for urinary excretion (k(10)) was slightly reduced by the preceding surgery, by a marked rise in plasma albumin, and by a high preinfusion urinary concentration of creatinine. The arterial pressure, body weight, and plasma concentrations of C-reactive protein and shedding products of the endothelial glycocalyx layer (syndecan-1, heparan sulfate, and hyaluronic acid) did not serve as statistically significant covariates. Conclusions There were no clinically relevant differences in the kinetics of 20% albumin between postoperative patients and volunteers.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 85, no 6, p. 1303-1311
Keywords [en]
albumin; fluid kinetics; heparan sulfate; hyperoncotic; syndecan-1
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Other Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-158059DOI: 10.1111/bcp.13897ISI: 000468974200027PubMedID: 30756411OAI: oai:DiVA.org:liu-158059DiVA, id: diva2:1329186
Note

Funding Agencies|Mats Kleberg Foundation

Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-06-24

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Zdolsek, MarkusZdolsek, Joachim
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDivision of Drug ResearchDepartment of Anaesthesiology and Intensive Care in Linköping (ANOPIVA)
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