Format

Send to

Choose Destination
See comment in PubMed Commons below
Semin Cardiothorac Vasc Anesth. 2014 Sep;18(3):252-9. doi: 10.1177/1089253214535667. Epub 2014 May 26.

Albumin-Beyond Fluid Replacement in Cardiopulmonary Bypass Surgery: Why, How, and When?

Author information

1
Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain emoret.germanstrias@gencat.cat.
2
Munich University Hospital, Munich, Germany.
3
San Donato Hospital, Milan, Italy.
4
Helsinki University Hospital, Helsinki, Finland.

Abstract

Maintaining vascular barrier competence, preventing interstitial edema, and keeping microcirculation intact is crucial to achieve an optimal outcome in cardiopulmonary bypass surgery (CPB). Blood contact with roller pumps and foreign surfaces during CPB induces shear stress and a pressure drop across the pump boot that leads to transient systemic activation of the inflammatory and hemostatic systems. Moreover, patients after CPB often need volume resuscitation using the smallest possible amount of colloid solution because of fluid overload. For this purpose, human-derived albumin may be preferred over synthetic colloids because CPB priming with albumin preserves oncotic pressure, prevents platelet adhesion, and likely induces less consumption of coagulation factors. In patients with increased bleeding or renal failure, albumin is a safe alternative because of its minimal side effects. Large, randomized clinical trials comparing the benefit of albumin versus other fluids are warranted in the future to define albumin's distinct role in select high-risk surgical populations.

KEYWORDS:

albumin; cardiopulmonary bypass; colloid; crystalloid

PMID:
24862323
DOI:
10.1177/1089253214535667
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Atypon
    Loading ...
    Support Center