The intravascular expansion effect of 20% albumin is roughly double its infused volume, although 15% greater again in the healthy versus those with sepsis.

pearl

• M P Margarson and N C Soni.
• Imperial College School of Science, Technology and Medicine, Magill Department of Anaesthesia, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. m.margarson@ic.ac.uk
• Br J Anaesth. 2004 Jun 1; 92 (6): 821-6.

BackgroundPatients with systemic sepsis develop a capillary leak syndrome, and serum -albumin concentration decreases. Hyperoncotic albumin infusion can be used for volume expansion in these patients, but the degree and duration of effect are not well described. We assessed volume expansion by albumin 20% infusion and compared the retention of infused albumin in septic patients and healthy controls.MethodsWe gave albumin 20%, 200 ml as a rapid infusion to 70 patients with septic shock and 26 controls. Blood samples were taken before and 1, 5, 15, 30, 60, 120 and 240 min after the infusion for measurement of serum albumin concentration and haematocrit. Haemodilution and the percentage of administered albumin remaining intravascularly at each time were calculated.ResultsThe mean proportion of the increase in albumin remaining at 4 h was 68.5 (sd 10)% in septic patients and 79 (5)% in controls (P<0.001). The albumin 20%, 200 ml caused a secondary fluid resorption and volume expansion maximal at 30 min, equivalent to a 430 ml infusion in septic patients and 500 ml in controls.ConclusionsAfter giving albumin, serum albumin concentrations decrease significantly faster in septic patients than in healthy controls.

22 keywords...

hide…