20% Human Albumin Solution Fluid Bolus Administration Therapy in Patients After Cardiac Surgery (the HAS FLAIR Study)

Wigmore, Geoffrey; Anstey, James; John, Ashley St.; Greaney, Joel; Morales-Codina, Marc; Presneill, Jeffrey; Deane, Adam M.; MacIsaac, Christopher; Bailey, Michael; Tatoulis, James; Bellomo, Rinaldo

doi:10.1053/j.jvca.2019.03.049

Cited by 33 publications

(59 citation statements)

References 24 publications

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“…Further description of the exclusion criteria can be found in the supplemental appendix. 1 We agree that the sequential period design increases the risk of confounding variables. 2 In our study the intervention group received 5 units of packed red blood cells and the control group 11 units.…”

Section: Conflicts Of Interestmentioning

confidence: 75%

“…We read with great interest the article by Mamo et al published in your journal, which compares the use of prophylactic noninvasive ventilation (NIV) with standard face mask oxygen therapy in postoperative thoracoabdominal aortic aneurysm (TAAA) surgical patients. 1 We consider the results and conclusions exciting from a practical perspective. However, some data should be considered for an adequate extrapolation and acceptance of the results.…”

Section: Conflict Of Interestmentioning

confidence: 97%

“…First, we would like to thank Curtis and Anwar for their interest in our article "20% Human Albumin Solution Fluid Bolus Administration Therapy in Patients After Cardiac Surgery (the HAS FLAIR Study)." 1 In their letter to the editor, Curtis and Anwar inquire about potential selection bias and confounders.…”

Section: Conflicts Of Interestmentioning

confidence: 99%

“…Blood products other than packed red blood cells were not recorded as fluid boluses, but their volume is accounted for in the total volume of fluid in the first 24 hours and net fluid positive balance at 24 hours postop ( Table 2). 1 The open label design increases the risk of other confounding interventions, such as furosemide, being coadministered. In our study, the intervention was as follows: 20% albumin was associated with less total dose of furosemide being administered (albumin: IV n = 2 and 170 mg, orally n = 1 and 40 mg versus crystalloid: IV n = 11 and 590 mg, orally n = 5 and 320 mg).…”

Section: Conflicts Of Interestmentioning

confidence: 99%

See 3 more Smart Citations

HAS FLAIR Investigators Reply to Fluid Resuscitation After Cardiac Surgery: The Quest for the Ideal Fluid

Wigmore

Anstey

Deane

et al. 2019

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Conflicts Of Interestmentioning

confidence: 75%

Section: Conflict Of Interestmentioning

confidence: 97%

Section: Conflicts Of Interestmentioning

confidence: 99%

Section: Conflicts Of Interestmentioning

confidence: 99%

See 2 more Smart Citations

HAS FLAIR Investigators Reply to Fluid Resuscitation After Cardiac Surgery: The Quest for the Ideal Fluid

Wigmore

Anstey

Deane

et al. 2019

Journal of Cardiothoracic and Vascular Anesthesia

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“…In this issue of the journal, an elegant study by Wigmore et al 10 gives ammunition to the "pro" side. In their single-center study, using small volumes of 20% albumin in cardiac surgical patients led to equivalent cardiovascular optimization but less fluid accumulation than when using solely crystalloid fluids.…”

mentioning

confidence: 99%

Fueling the Debate on Albumin After Cardiac Surgery

Mwaura

Vuylsteke

2019

Journal of Cardiothoracic and Vascular Anesthesia

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The Case for Albumin as Volume Expander and beyond

Nasa,

Kumar,

Juneja

et al. 2023

Rational Use of Intravenous Fluids in Critically Ill Patients

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This chapter discusses the importance of endogenous albumin, the most abundant plasma protein in the body. Albumin has diverse functions such as antioxidant, anti-inflammatory activities, intravascular buffering, drug metabolism, transport, distribution, and restoration of vascular endothelial integrity. It is also crucial for maintaining the endothelial glycocalyx layer in blood vessels. Critically ill patients may experience hypoalbuminemia, defined as serum albumin <35 g/L, due to reduced synthesis, malnutrition, increased loss, or increased catabolism. Observational studies show hypoalbuminemia as an independent predictor of worse outcomes, with a 10 g/L decrease in serum albumin linked to a higher risk of mortality, morbidity, longer ICU/hospital stays, and increased resource utilisation. Administering exogenous albumin targeting serum albumin >30 g/L may reduce complications, but further trials are needed. Exogenous albumin is used in the ICU for various indications, including resuscitation and deresuscitation. Evidence on its use as a plasma expander is inconclusive. Both high- (20%) and low-concentration (4 and 5%) albumin can be used for resuscitation if patients require additional fluid, despite receiving crystalloids. Albumin is safe and effective for plasma expansion in patients with sepsis and septic shock but should be avoided in traumatic brain injury. Judicious and vigilant use of albumin is recommended due to its cost and potential risks. Albumin administration should be based on clinical indications, and monitoring fluid balance and clinical parameters is critical to prevent fluid accumulation and oedema formation.

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20% Human Albumin Solution Fluid Bolus Administration Therapy in Patients After Cardiac Surgery (the HAS FLAIR Study)

Cited by 33 publications

References 24 publications

HAS FLAIR Investigators Reply to Fluid Resuscitation After Cardiac Surgery: The Quest for the Ideal Fluid

HAS FLAIR Investigators Reply to Fluid Resuscitation After Cardiac Surgery: The Quest for the Ideal Fluid

Fueling the Debate on Albumin After Cardiac Surgery

The Case for Albumin as Volume Expander and beyond

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