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Exploding the albumin myth

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Abstract

In this article arguments are given to stop the current practise of infusing albumin in patients in shock and low levels of serum albumin. Correcting the albumin levels is not correlated with better survival or change in morbidity. Fluid therapy including the use of synthetic plasma expanders is the accepted therapy for patients in sceptic shock.

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Literature

  1. Yim JM, Vermeulen LC, Erstad BL, Matuszewski KA, Burnett DA, Vlasses PH. Albumin and nonprotein colloid solution use in US Academic Health Centers. Arch Intern Med 1995;155: 2450-5.

    PubMed  Google Scholar 

  2. Vermeulen LC, Ratko TA, Erstad BL, Brecher ME, Matuszewski KA, for the members of the University Hospital Consortium Consensus Exercise on the use of albumin, nonprotein colloid and crystalloid solutions. Arch Intern Med 1995;155:373-79.

    PubMed  Google Scholar 

  3. Rotschild MA, Albumin synthesis (1). N Engl J Med 1972;286:748-57.

    PubMed  Google Scholar 

  4. Rotschild MA. Albumin synthesis (2). N Engl J Med 1972;286:816-20.

    PubMed  Google Scholar 

  5. Tullis JL. Albumin 1: Background and use. JAMA 1977; 237:355-9.

    PubMed  Google Scholar 

  6. Marty AT. Hyperoncotic albumin therapy. Surg Gynecol Obstet 1974;139: 105-9.

    PubMed  Google Scholar 

  7. Rothschild MA, Oratz M, Schreiber S. Albumin metabolism. Gastroenterology 1973;64: 324-37.

    PubMed  Google Scholar 

  8. Doweiko JP, Nompleggi DJ. Role of albumine in human physiology and pathophysiology. JPEN 1991;15: 207-11.

    Google Scholar 

  9. Margarson M, Soni N. Albumin physiology in the septic and postoperative patient. In Vincent JL, ed. Yearbook of Intensive Care and Emergency Medicine 1997. Berlin-Heidelberg: Springer-Verlag.

    Google Scholar 

  10. Madras NE, Ayuis JC, Adrogue HJ. Increased anion gap in metabolic alkalosis. N Engl J Med 1979;300: 1421-3.

    PubMed  Google Scholar 

  11. Belpaire FM, Bogaert MG. Binding to albumin and alpha-1 acid glycoprotein as a source of variability in drug disposition. In Breimer DD, Crommelin DJA, Midha KK, eds. Topics in Pharm. Sciences 1989, Proc. 49th Int. Congr. Pharm. Sci. of FIP Munich, Germany, 4-9 sept.1989. The Hague: FIP, 1989.

    Google Scholar 

  12. Kaminski MV, Haase TJ, Albumin and colloid osmotic pressure implications for fluid resuscitation. Critical Care Clinics 1992;8(2):311-21.

    PubMed  Google Scholar 

  13. Gaks BJ, Erstad BL, Adverse reactions to human serum albumin. Ann Pharmacother 1993;27:87-94.

    PubMed  Google Scholar 

  14. Jorgenson KA, Stofferson E. On the inhibitory effect of albumin on platelet aggregation. Thromb Res 1980;17:13-8.

    PubMed  Google Scholar 

  15. Lucas CE, Bouwman DL, Ledgerwood AM, Higgins RF. Differential serum protein changes following supplemental albumine resuscitation for hypovolemic shock. J Trauma 1980;20:47-51.

    PubMed  Google Scholar 

  16. Wilkinson P, Sherlock S. The effect of repeated albumin infusions in patients with cirrhosis. Lancet 1962;2:1125-9.

    PubMed  Google Scholar 

  17. Kovalik SG, Ledgerwood AM, Lucas CE, Higgins RF. The cardiac effect of altered calcium homeostasis after albumin resuscitation. J Trauma 1981;21:275-9.

    PubMed  Google Scholar 

  18. Moyer ED, Border JR, Cerra FB, Caruana J, Chenier R, Mc Menamy RH. Multiple systems organ failure IV. Imbalances in plasma amino acids associated with exogenous albumin in the trauma-septic patient. J Trauma 1981;21:543-7.

    PubMed  Google Scholar 

  19. Grootendorst AF, Wilgenburg MGM van, Laat PHJM de, Hoven B van der. Albumin abuse in intensive care medicine. Intensive Care Med 1988;14:554-7.

    PubMed  Google Scholar 

  20. Foley EF, Borlasse BC, Dzik WH, Bistrian BR, Benotti PN. Albumin supplementation in the critically ill. Arch Surg 1990;125:739-42.

    PubMed  Google Scholar 

  21. Brown RO, Bradley JE, Bekemeyer WB, Luther RW. Effect of albumin supplementation during parenteral nutrition on hospital mortidity. Crit Care Med 1988;16:1177-82.

    PubMed  Google Scholar 

  22. Stockwell MA, Soni N, Riley B. Colloid solutions in the critically ill (1). Anaesthesia 1992;47:3-6.

    PubMed  Google Scholar 

  23. Stockwell MA, Scott A, Dey A, Riley B, Soni N. Colloid solutions in the critically il(2). Anaesthesia 1992;47:7-9.

    PubMed  Google Scholar 

  24. Griffel MI, Kaufman BS. Pharmacology of colloids and crystalloids. Critical Care Clinics 1992;8:235-53.

    Google Scholar 

  25. Imm A, Carlson RW. Fluid resuscitation in circulatory shock. Critical Care Clinics 1993;9:313-33.

    PubMed  Google Scholar 

  26. Shoemaker WC, Appel PL, Kram HB. Prospective trial of supranormal values of survivors as therapeutic goals. Chest 1988;94:1176-86.

    PubMed  Google Scholar 

  27. Salmon JB, Mythen MG. Pharmacology and physiology of colloids. Blood Reviews 1993;114-20.

  28. De Wolf PJ, Kloeg PHAM, Jong M de, Steenhoek A. Is albumine 20% te vervangen door hydroxyethylzetmeel 10% op geleide van de COD? Ziekenhuisfarmacie 1992;8:8-15.

    Google Scholar 

  29. Blackburn GL, Driscoll DF. Time to abandon routine albumine supplementation. Crit Care Med 1992;20:157-8.

    PubMed  Google Scholar 

  30. De Gaudio AR, Paternostro E, Signorini P. Albumina esogena e paziente critico. Riviste Italiana Nutrizione Parenterale ed Enterale 1993;11:135-46.

    Google Scholar 

  31. Boldt J, Mentges D, Papsdorf M. Volume therapy: new aspects of an old topic? In Vincent JL, ed. Yearbook of Intensive Care and Emergency Medicine 1997. Berlin-Heidelberg: Springer Verlag.

    Google Scholar 

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Tjoeng, M., Bartelink, A. & Thijs, L. Exploding the albumin myth. Pharm World Sci 21, 17–20 (1999). https://doi.org/10.1023/A:1008637528580

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  • DOI: https://doi.org/10.1023/A:1008637528580

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